Women with severe nausea in pregnancy are more likely to experience depression before and after delivery

Severe toxicosis of pregnancy (hyperemesis gravidarum) is associated with an increased risk of depression both before and after pregnancy. This conclusion was reached by scientists at the University of Turku (Finland), having analysed the data of hundreds of thousands of women. The results are published in the journal The Lancet Psychiatry, reports the University of Turku.

Pregnancy hyperemesis gravidarum is an extremely severe form of nausea and vomiting during pregnancy, in which a woman is almost unable to eat and drink normally, and everyday life becomes extremely difficult. The condition occurs in about 0.3-3.6% of pregnancies and is the most common cause of hospitalisation in the first trimester.

In addition to the physical symptoms, severe nausea has a serious psychosocial burden. Until now, however, there has been little data on its association with psychiatric disorders.

Researchers from the University of Turku conducted a national registry study in which they compared cases of severe nausea in pregnancy with diagnoses of depression. For the first time, the link was shown to be two-way: pregnancy hyperemesis gravidarum was associated with depression both before pregnancy and in the years following delivery.

The work was carried out as part of a large LopuJo project led by Prof Päivi Polo. The analysis included data from more than 437,000 Finnish women who gave birth between 2004 and 2017.

The results showed that among women with severe nausea during pregnancy, depression before conception occurred in 8.8 per cent of cases, compared to only 1.0 per cent of the control group. This means that the risk of pre-existing depression was more than five times higher in these patients.

After delivery, women with hyperemesis gravidarum were also more likely to have new, previously undiagnosed depression: 4.9 per cent versus 1.0 per cent in the control group - about 3.5 times more likely.

In addition, depression was detected earlier in those with severe toxicity, on average 3.3 years after delivery, compared with about 4.5 years in the comparison group.

The authors suggest that severe nausea during pregnancy and depression may share common biological mechanisms. The findings emphasise the importance of systematic psychiatric screening during pregnancy and postpartum, and the need for a multidisciplinary approach to the management of these patients.

"Our study shows that severe nausea in pregnancy is not only a physically debilitating condition but also a significant risk factor for mental health. The results emphasise the need for psychiatry, gynaecology and primary care to work more closely together. We also want to raise awareness and improve access to support for these patients," says PhD student Eeva Terawa-Utti from the University of Turku.