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Review
. 2025 May;54(5):906-914.
doi: 10.18502/ijph.v54i5.18626.

Adverse Neonatal Outcomes in Pregnant Women with Severe Vomiting: A Meta-Analysis

Yuliu Huang  1 , Shuixia Chen  2
Affiliations
Review

Adverse Neonatal Outcomes in Pregnant Women with Severe Vomiting: A Meta-Analysis

Yuliu Huang et al. Iran J Public Health. 2025 May.

Abstract

Background: We aimed to systematically evaluate the risk of negative effect for newborns born to expectant mothers with severe vomiting in terms of birth weight, premature delivery, low Apgar score, and NICU hospitalization.

Methods: We conducted a systematically search for relevant studies on PubMed, Embase, Cochrane Library, and CNKI databases, using Newcastle-Ottawa Scale to evaluate research quality, and RevMan 5.3 software for meta-analysis from 2009 to 2022. The main outcome measures were: Low-birth weight, preterm delivery, low Apgar score and growth restriction.

Results: In 9 studies, the risk of Low birth weight in hyperemesis pregnant women was increased, and the random effect model was OR 2.38 (95% CI 0.43 to 13.13). The heterogeneity of the study was high (I2=100%). Four studies showed an increased risk of low Apgar scores, with an OR of 2.69 (95% CI 0.30 to 24.48), and high heterogeneity (I2=95%). The risk of premature birth in 5 papers is equivalent, with an OR of 0.93 (95% CI 0.71 to 1.22) and low heterogeneity (I2=6%). The risk of growth restriction was higher in 7 papers, with an OR of 1.31 (95% CI 0.93 to 1.85) and lower heterogeneity (I2=29%). Subgroup analysis showed that heterogeneity mainly stemmed from differences in the definition of hyperemesis.

Conclusion: Pregnant women with severe vomiting have a higher risk of giving birth to babies with low birth weight and low Apgar scores, and a higher risk of giving birth to babies with growth restriction, but the risk of premature birth is comparable.

Keywords: Adverse outcomes; Dramatic vomiting; Newborns; Pregnant and parturient women.

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Figures

Fig. 1.
Fig. 1.
Flow chart of the literature search
Fig. 2:
Fig. 2:
Summary Results of Literature Bias Risk
Fig. 3:
Fig. 3:
Forest plot of maternal emesis and neonatal outcome indicators A: Forest map of the occurrence of LBW in newborns of pregnant women with and without severe vomiting. B: Forest map of the occurrence of LASs in newborns of pregnant women with and without severe vomiting. C: Forest map of the incidence of premature birth in newborns of pregnant women with and without hyperemesis. D: Forest map of the occurrence of neonatal growth restriction in pregnant women with and without severe vomiting
Fig. 4:
Fig. 4:
Subgroup analysis results A: Subgroup analysis of the incidence of LBW in newborns of pregnant women with and without hyperemesis. B: Specific definition subgroup analysis of the incidence of low birth weight in newborns of pregnant women with and without severe vomiting
See this image and copyright information in PMC

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