The perception of teratogenic risk by women with nausea and vomiting of pregnancy

This study determined the advice reported to be received by women suffering from nausea and vomiting of pregnancy (NVP) from their caregivers regardin g management, the teratogenic risk perception of these women and their choi ce of antiemetic drug use in pregnancy. A secondary objective was to determ ine prospectively the effect of counseling on malformation risk perception in women with NVP. The women were prospectively followed-up and questioned about the use of pharmacotherapy or other management choices as well as the ir perception of teratogenic risk through structured telephone interviews. The results showed that at the initial call, around 6 weeks of gestation, o ver three quarters of the 260 participants reported that therapy of NVP inc reased their teratogenic risk. This risk perception was decreased significa ntly after counseling. Women who reported their physicians' advice to chang e their diet and/or lifestyle attributed an increased risk for major malfor mations with antiemetics for NVP (P = 0.001), whereas women who reported ad vice to take antiemetic medications known to be safe to the fetus attribute d no change in risk for major malformations with drugs for NVP (P = 0.002). We came to the conclusion that women are commonly hesitant to treat NVP ph armacologically due to unfounded fears of teratogenic risk. Evidenced-based counseling resulted in reduced numbers of women who considered drug therap y for NVP to increase the risk of major malformations. (C) 1999 Elsevier Sc ience Inc. All rights reserved.