Severe nausea in pregnancy linked to 50% higher risk of mental health issues

Hyperemesis gravidarum during pregnancy raises the risk of mental health issues by over 50%, including post-partum depression, psychosis, and PTSD. Severe HG can cause metabolic disturbances, underlining the importance of mental health support and specialist care.

New Delhi: Women with excessive nausea and vomiting (hyperemesis gravidarum) during pregnancy may be at a 50 per cent high risk of mental health conditions such as post-partum psychosis, depression, and post-traumatic stress disorder, according to a study.

Hyperemesis gravidarum (HG) affects up to 3.6 per cent of all pregnancies. HG is the most common cause of hospitalisation in the first trimester of pregnancy, and the majority of HG cases (but not all) resolve in the second trimester.

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Women with HG experience prolonged and severe nausea and vomiting, leading to dehydration and weight loss. In the study, published in The Lancet Obstetrics, Gynaecology, & Women’s Health, UK researchers examined 24 neuropsychiatric and mental health-related outcomes reported within a year of diagnosis in 476,857 pregnant women.

Whilst previous research had shown that women with HG are at an increased risk of anxiety, depression, and PTSD, the new study found over 50 per cent increased risk in 13 conditions, including post-partum psychosis and post-traumatic stress disorder.

The risks were doubled for Wernicke’s encephalopathy (a neurological condition due to vitamin B1 deficiency), refeeding syndrome (complications arising when food is introduced too quickly to someone who has been malnourished), eating disorders, and depression, particularly post-partum depression, which was 2.7 times more likely.

“Many pregnant women experience nausea and vomiting, but for women with HG, this occurs at a level which is far from ‘normal’ and as such it can be profoundly debilitating. Many of these conditions would warrant urgent referral to specialist services for urgent assessment and treatment to ensure the safety of mother and child,” said Dr Hamilton Morrin, Doctoral Fellow at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London. In the ICD-11, the latest International Classification of Diseases by the World Health Organisation, HG is subcategorised into “mild HG” and “HG with metabolic disturbance”.

The latter is characterised by carbohydrate depletion, dehydration, or electrolyte imbalance. The researchers also examined whether this categorisation is correlated with mental health outcomes. Importantly, cases of HG with metabolic disturbance (perceived as more severe) showed significantly reduced risk of depression compared to mild HG.

This finding highlights the importance of adequate mental health screening and support for all women with HG, regardless of perceived severity.