Neurodevelopment of Children After Maternal Hospitalization for Nausea and Vomiting of Pregnancy [252].

INTRODUCTION: Child outcomes associated with severe maternal nausea and vomiting of pregnancy are understudied. The study objective was to determine child long-term neurodevelopment after maternal hospitalization for severe nausea and vomiting of pregnancy.

METHODS: Motherisk NVP Helpline callers from 2006 to 2012 were identified from our prospectively collected database. Women with nausea and vomiting of pregnancy treated with doxylamine-pyridoxine (Diclectin/Diclegis) or with no pharmacotherapy were included. Diclectin/Diclegis dose, severity of nausea and vomiting of pregnancy, hospitalization for nausea and vomiting of pregnancy, concomitant medications, severity of maternal depression, and maternal intelligence quotient (IQ) were obtained. Children (ages 3 6/12 to 6 11/12 years) were assessed using standardized psychological tests. The study cohort was divided into three groups: 1) nausea and vomiting of pregnancy treated with more than four tablets per day of Diclectin/Diclegis (above the manufacturer-recommended number of tablets) (n=62); 2) nausea and vomiting of pregnancy treated with the recommended up to four tablets per day (n=81); and 3) nausea and vomiting of pregnancy and no pharmacotherapy (n=76).

RESULTS: Twenty-two women were hospitalized for severe nausea and vomiting of pregnancy. The hospitalized women initiated recommended preventive antiemetics significantly later (6.8 compared with 5.7 weeks, P=.02), experienced more severe nausea and vomiting of pregnancy (11.1 compared with 7.5, P<.001), and depression (10.1 compared with 5.1, P=.03) and needed higher daily doses of Diclectin/Diclegis (1.0 compared with 0.4 mg/kg per day, P<.001) and concomitant medications. Children of hospitalized mothers achieved significantly lower IQ scores (verbal 107.2 compared with 112.7, P=.04; performance 105.6 compared with 112.3, P=.03; full scale 108.7 compared with 114.2, P=.05). Duration of hospitalization, maternal depression, and maternal IQ were significant predictors for these outcomes. Daily intake of Diclectin/Diclegis was not associated with any adverse outcomes.

CONCLUSION: Timely preventive antiemetics and depression control may prevent hospitalization and be associated with favorable child neurodevelopment. More research is needed to investigate the effect of severe nausea and vomiting of pregnancy and confirm these results.