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Review
. 2016 Feb 4;8(Suppl 1):23-32.
doi: 10.4137/NMI.S29532. eCollection 2015.

A Systematic Review and Meta-Analysis of the Utility of Corticosteroids in the Treatment of Hyperemesis Gravidarum

Iris J Grooten  1 , Margot E Vinke  2 , Tessa J Roseboom  1 , Rebecca C Painter  3
Affiliations
Review

A Systematic Review and Meta-Analysis of the Utility of Corticosteroids in the Treatment of Hyperemesis Gravidarum

Iris J Grooten et al. Nutr Metab Insights. .

Abstract

Background: Corticosteroids (CCS) are effective in reducing chemotherapy-induced nausea and vomiting, but it is unknown whether CCS are effective in treating hyperemesis gravidarum (HG).

Methods: We searched PubMed and ClinicalTrials.gov from inception to May 15, 2015, for randomized controlled trials examining the effects of CCS in HG.

Results: We identified five trials (n = 310) examining the effects of CCS in women with HG. Meta-analysis was possible for one outcome (n = 214) and showed no significant effect of CCS on readmission rates (odds ratio, 0.37; 95% confidence internal: 0.1-1.35). Two small studies (n = 104) reported a reduction of vomiting episodes, and one (n = 24) found improvement of well-being, but no effect on other outcomes. None of the studies that investigated perinatal outcome (n = 173) found an effect of CCS and were underpowered to investigate teratogenic effects. We found evidence of publication bias.

Conclusion: Meta-analysis yielded no effect of CCS therapy on readmission rates. Single small studies indicated possible beneficial effects on other outcomes. Future high-quality trials are necessary and would benefit from consensus on HG definition and core outcomes of HG therapy.

Keywords: corticosteroids; effectiveness; hyperemesis gravidarum; treatment.

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Figures

Figure 1
Figure 1
Flowchart of study selection. Note: *An updated version of the article was available.
Figure 2
Figure 2
Summary risk of bias.
Figure 3
Figure 3
Forest plot of hospital readmissions for HG after treatment with corticosteroids compared to placebo or alternative therapy.
Figure 4
Figure 4
Funnel plot illustrating possible publication bias for studies reporting on hospital readmissions for HG after treatment with corticosteroids.
See this image and copyright information in PMC

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