Interventions initiated before and after pregnancy for women who experience severe nausea and vomiting of pregnancy: a scoping review

Introduction: Nausea and vomiting of pregnancy (NVP) affects up to 90% of women, while hyperemesis gravidarum (HG), a severe form of NVP, impacts quality of life, and ability to eat and drink normally, with reported recurrence rates up to 89% in subsequent pregnancies. Severe NVP has a profound impact on maternal physical and mental health, impairing daily functioning and quality of life, and is associated with anxiety and depression

Aims: To conduct a scoping review to identify and characterise interventions initiated before and after pregnancy that aim to mitigate the impact and consequences of severe NVP on maternal health.

Methods: A comprehensive search was conducted across seven electronic databases and included grey literature without restrictions on language or date. Eligible studies were identified according to a prespecified criteria. All references were screened independently by two reviewers.

Findings: Three studies were included; two utilised pre-emptive counselling and antiemetic treatment beginning before pregnancy or in early pregnancy/upon recognition of pregnancy, while one focused on post-pregnancy writing therapy. Both pre-emptive interventions reported a reduction in NVP symptom severity and a lower recurrence rate of HG, while writing therapy was beneficial in aiding recovery from severe NVP and allowed women an opportunity to externalise and process the experience.

Discussion: This study revealed a paucity of interventions initiated before and after pregnancy for women with severe NVP. The included studies showed some benefits of pre-emptive treatment and writing therapy.

Conclusion: Tailored pre-pregnancy and postpartum interventions for women with previous severe NVP are urgently needed to address the physical and mental health burden of the condition.