Psychosocial morbidity among women with nausea and vomiting of pregnancy: prevalence and association with anti-emetic therapy

Unlike severe nausea and vomiting of pregnancy (NVP), it is not known wheth er milder forms of NVP have been associated with psychosocial morbidity. We undertook the study to explore the prevalence of psychosocial morbidity by severity of NVP, and determine whether after correction for severity of na usea/vomiting, there is a relationship between psychosocial morbidity and w omen's decisions to take anti-emetics as a reflection of their distress due to NVP. From 1996-97, an NVP Healthline was advertised. Callers underwent semi-structured interviews about both their NVP and associated psychosocial morbidity in a previous pregnancy. Most of the 3201 callers resided in Can ada, worked outside the home, reported on planned pregnancy (a median of) 4 years before, and described severe (> 5 episodes/day of) nausea and vomiti ng. More severe nausea/vomiting was associated with more frequent feelings of depression, consideration of termination of pregnancy, adverse effects o n women's relationships with their partners or their partners' everyday liv es, and the perceived likelihood that NVP would harm their baby (p < 0.0001 ). However, all psychosocial factors were reported by a clinically importan t proportion of women with mild nausea/vomiting (0-1 episodes/day). The sev erity of vomiting was most closely related to women's decisions to take ant i-emetics, but other psychosocial factors were also independently associate d with anti-emetic therapy. We conclude that psychosocial morbidity is evident across the spectrum of s everity of nausea and vomiting among women with NVP The severity of nausea or vomiting does not appear adequately to reflect the distress caused by NV P, as reflected by women's decisions to fake anti-emetic therapy.