Nausea, vomiting, and heartburn in pregnancy: a prospective look at risk, treatment, and outcome

Abstract

Objective: To examine risk factors, treatment, and outcomes for nausea/vomiting (N/V) and heartburn during pregnancy. Methods: We included 2731 women from a prospective cohort study of gallbladder disease in pregnancy. Subjects completed questionnaires at enrollment, early third trimester, and 4–6 weeks postpartum. We used logistic regression to examine independent predictors of upper gastrointestinal symptoms. Results: Ninety-five percent of pregnant women experienced either heartburn and/or N/V. Independent predictors for heartburn included prepregnancy heartburn (OR 5.28, 95% CI 3.78–7.37), multigravidity, prepregnancy body mass index, and pregnancy weight gain. Independent predictors for N/V included prepregnancy N/V (OR 2.25, 95% CI 1.52–3.31), other digestive problems prepregnancy, younger age, single gestation, and carrying a female fetus. 11% of women with N/V and 47% of women with heartburn used pharmacologic therapy. Infants born to women with heartburn had significantly higher birth weights (p = 0.03), but gestational age at delivery was not significantly different. N/V was not associated with birth weight or gestational age at delivery. 19.7% of women with heartburn during pregnancy reported postpartum heartburn. Conclusions: Heartburn and N/V are common pregnancy symptoms, particularly among women with a history of such symptoms. Neither condition appears to adversely affect the outcome of pregnancy. Pregnancy-related heartburn predisposes to early postpartum heartburn.

Keywords::

• Gastroesophageal reflux disease
• pregnancy complications
• pregnancy outcomes
• proton pump inhibitors
• body mass index

Acknowledgments

The authors acknowledge the contributions of Lorna Imbruglio RN, Shirley Beresford PhD, and Sum Lee MD PhD to this study.

Declaration of Interest: The authors report no declarations of interest.