The effect of Acid-reducing pharmacotherapy on the severity of nausea and vomiting of pregnancy

Abstract

Background. Heartburn and acid reflux (HB/RF) are associated with increased severity of nausea and vomiting. The ability of acid-reducing drugs to reduce symptoms of nausea and vomiting of pregnancy has not been previously tested. Objective. To determine whether acid-reducing pharmacotherapy decreases the severity of NVP symptoms. Methods. We studied a cohort of women experiencing NVP, who were also experiencing HB/RF. Women were counseled to commence acid-reducing pharmacotherapy. The effectiveness of the acid-reducing medication in decreasing symptoms of both HB/RF and NVP was measured. Results. Acid-reducing drugs resulted in significant decreases in PUQE (9.6 +/- 3.0 to 6.5 +/- 2.5, P < .0001) and well-being scores from the initial (4.0 +/- 2.0) to the follow-up interview (6.8 +/- 1.6, P < .0001). After intervention with acid-reducing pharmacotherapy, a reduction in acid symptoms correlated significantly with reduction in NVP (R(2) = 0.72, P < .001). Conclusion. This is the first study to demonstrate that management of HB/RF can reduce the severity of NVP.

Figure 1

PUQE scores of women experiencing HB/RF and NVP at initial call and at follow-up after the use of acid-reducing pharmacotherapy; Final (marked “∗”): P < .0001, compared to control.

Figure 2

Well-being scores of women experiencing HB/RF and NVP at initial call and at follow-up after the use of acid-reducing pharmacotherapy; Final (marked “∗”): P < .0001, compared to control.

Figure 3

Linear regression comparing the effectiveness of acid-reducing pharmacotherapy in reducing HB/RF, and in reducing NVP. Women rated effectiveness from zero (no effect) to 10 (maximal effect); R ² = 0.72, P < .001.