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2017 ; 44
(4
): 384-389
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Hospital admission for hyperemesis gravidarum in women at increased risk of
spontaneous preterm birth
#MMPMID28857251
Kleine I
; Da Silva A
; Ahmed W
; Forya F
; Whitten SM
; David AL
; James CP
Birth
2017[Dec]; 44
(4
): 384-389
PMID28857251
show ga
BACKGROUND: Progesterone administration prevents spontaneous preterm birth (sPTB)
in women at increased risk. Progesterone concentration is lower in women with
subsequent sPTB. Conversely, high concentrations of progesterone are implicated
in the pathogenesis of hyperemesis gravidarum (HG). We hypothesized that women at
increased risk of sPTB or spontaneous late miscarriage would be less likely to
have a diagnosis of HG. To explore this hypothesis, we compared the incidence of
HG in women at increased risk of sPTB and women with no identifiable risk
factors. METHODS: Women at increased risk of sPTB were identified from a
specialist Preterm Birth Clinic (PTBC) database where criteria for PTBC
attendance are previous cervical surgery, previous sPTB <34 weeks, previous
spontaneous late miscarriage, incidental sonographic cervical shortening, and
uterine anomaly. Hospital antenatal booking and coding records for the same time
period were examined to identify HG admissions. Women with multiple gestations,
trophoblastic disease, or pre-existing abnormal thyroid function were excluded.
The incidence of HG among PTBC (n=394) and non-PTBC attendees (n=4762) was
calculated. RESULTS: The incidence of HG was lower in women at increased risk of
sPTB (1.52%, n=6) compared with women with no identifiable risk factor for sPTB
(3.33%, n=159; P=.049). CONCLUSION: Hospital admission for HG is reduced in women
with risk factors for sPTB compared with those without risk factors. Exploration
of the pathogenesis of HG may improve understanding of the mechanisms underlying
sPTB.
|Female
[MESH]
|Hospitalization/*statistics & numerical data
[MESH]