Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The psychosocial burden of hyperemesis gravidarum



To describe the psychosocial burden of hyperemesis gravidarum (HG) in a large cohort of affected women, focusing on previously unreported problems.

Study Design:

Women with HG described their pregnancy history in an open-ended survey administered internationally through an HG website during 2003 to 2005.


Of the 808 participants, 626 (77.5%) were American. A large majority (82.8%) reported that HG caused negative psychosocial changes, consisting of (1) socioeconomic changes, for example, job loss or difficulties, (2) attitude changes including fear regarding future pregnancies and (3) psychiatric sequelae, for example, feelings of depression and anxiety, which for some continued postpartum. Women who reported that their health-care provider was uncaring or unaware of the severity of their symptoms were nearly twice as likely to report these psychiatric sequelae (odds ratio 1.86, 95% confidence interval 1.06 to 3.29, P=0.032).


Over 80% of a large cohort of women with HG reported that HG caused a negative psychosocial impact.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout


  1. Jarnfelt-Samsioe A . Nausea and Vomiting in pregnancy: a review. Obstet Gynec Surv 1987; 41 (7): 422–426.

    Article  Google Scholar 

  2. Fairweather DV . Nausea and vomiting in pregnancy. Am J Obstet Gynecol 1968; 102 (1): 135–175.

    Article  CAS  Google Scholar 

  3. Goodwin TM . Hyperemesis gravidarum. Clin Obstet Gynecol 1998; 41 (3): 597–605.

    Article  CAS  Google Scholar 

  4. Association of Professors of Gynecology and Obstetrics. Nausea and Vomiting of Pregnancy. Educational Series on Women's Health Issues. ACOG: Crofton, MD, 2001.

  5. Hill JB, Yost NP, Wendel Jr GD . Acute renal failure in association with severe hyperemesis gravidarum. Obstet Gynecol 2002; 100 (5 Part 2): 1119–1121.

    PubMed  Google Scholar 

  6. Dodds L, Fell DB, Joseph KS, Allen VM, Butler B . Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol 2006; 107 (2 Part 1): 285–292.

    Article  Google Scholar 

  7. Bashiri A, Neumann L, Maymon E, Katz M . Hyperemesis gravidarum: epidemiologic features, complications and outcome. Eur J Obstet Gynecol Reprod Biol 1995; 63 (2): 135–138.

    Article  CAS  Google Scholar 

  8. Bailit JL . Hyperemesis gravidarum: epidemiologic findings from a large cohort. Am J Obstet Gynecol 2005; 193 (3 Part 1): 811–814.

    Article  Google Scholar 

  9. Adams MM, Harlass FE, Sarno AP, Read JA, Rawlings JS . Antenatal hospitalization among enlisted servicewomen 1987–1990. Obstet Gynecol 1994; 84 (1): 35–39.

    CAS  PubMed  Google Scholar 

  10. Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams MM, Deshpande AD et al. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol 2002; 100: 94–100.

    PubMed  Google Scholar 

  11. Jiang HG, Elixhauser A, Nicholas J, Steiner C, Reyes C, Brierman AS . Care of women in US Hositals, 2000. Agency for Healthcare Research and Quality: Rockville, MD, 2002 HCUP Fact Book No. 3. AHRQ Pub. No. 02-0044.

    Google Scholar 

  12. Gadsby R, Barnie-Adshead AM, Jagger C . A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract 1993; 43 (371): 245–248.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Vellacott ID, Cooke EJA, James CE . Nausea and vomiting in early pregnancy. Int J Gynaecol Obstet 1988; 27 (1): 57–62.

    Article  CAS  Google Scholar 

  14. O’Brien B, Naber S . Nausea and vomiting during pregnancy: effects on the quality of women's lives. Birth 1992; 19 (3): 138–143.

    Article  Google Scholar 

  15. Attard CL, Kohli MA, Coleman S, Bradley C, Hux M, Atanackovic G et al. The burden of illness of nausea and vomiting of pregnancy in the United States. Am J Obstet Gynecol 2002; 186 (5 Suppl): S220–S227.

    Article  Google Scholar 

  16. Chandra K, Magee L, Koren G . Discordance between physical symptoms versus perception of severity by women with nausea and vomiting of pregnancy (NVP). BMC Pregnancy Childbirth 2002; 24 (2): 71–75.

    Google Scholar 

  17. Mazzotta P, Stewart D, Atanackovic G, Koren G, Magee LA . Psychosocial morbidity among women with nausea and vomiting of pregnancy: prevalence and association with anti-emetic therapy. J Psychosom Obstet Gynecol 2000; 21 (3): 129–136.

    Article  CAS  Google Scholar 

  18. Tylden E . Hyperemesis and physiological vomiting. J Psychosom Res 1968; 12 (1): 86–93.

    Article  CAS  Google Scholar 

  19. EL-Mallakh RS, Liebowitz NR, Hale MS . Hyperemesis gravidarum as conversion disorder. J Nerv Ment Dis 1990; 178 (10): 655–659.

    Article  CAS  Google Scholar 

  20. Lingam R, McCulskey S . Eating disorders associated with hyperemesis gravidarum. J Psychosom Res 1996; 40 (3): 231–234.

    Article  CAS  Google Scholar 

  21. Katon WJ, Ries RK, Bokan JA, Kleinman A . Hyperemesis gravidarum: a biopsychosocial perspective. Int J Psychol Med 1980; 10 (2): 151–161.

    Article  Google Scholar 

  22. Munch S, Schmitz MF . Hyperemesis gravidarum and patient satisfaction: a path model of patients’ perceptions of the patient-physician relationship. J Psychosom Obstet Gynecol (271); 2006: 49–57.

    Google Scholar 

  23. Simpson SW, Goodwin TM, Robins SB, Rizzo AA, Howes RA, Buckwalter DK et al. Psychological factors and hyperemesis gravidarum. J Womens Health Gend Based Med 2001; 10 (5): 471–477.

    Article  CAS  Google Scholar 

  24. Flaxman SM, Sherman PW . Morning sickness: a mechanism for protecting mother and embryo. Q Rev Biol 2000; 75: 113–148.

    Article  CAS  Google Scholar 

  25. Zhang J, Cai WW . Severe vomiting during pregnancy: antenatal correlates and fetal outcomes. Epidemiology 1991; 2: 454–457.

    Article  CAS  Google Scholar 

Download references


This research was supported in part by the Intramural Research Program of the National Institute of Child Health and Human Development, National Institute of Health, Department of Health and Human Services.

Author information

Authors and Affiliations


Corresponding author

Correspondence to L M Korst.

Appendix A

Appendix A

Survey questions relevant to this study.

  1. 1

    What was your health provider's attitude toward hyperemesis care and you?

    1. a)

      Overall very supportive and helpful

    2. b)

      Eventually realized how sick I was and helped me

    3. c)

      Did not understand how sick I was

    4. d)

      Overall not sympathetic or caring

  2. 2

    What specific treatments were offered for hyperemesis?

  3. 3

    How has your life or future plans changed after experiencing hyperemesis?

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Poursharif, B., Korst, L., Fejzo, M. et al. The psychosocial burden of hyperemesis gravidarum. J Perinatol 28, 176–181 (2008).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


This article is cited by


Quick links