The effect of heartburn and acid reflux on the severity of nausea and vomiting of pregnancy

BACKGROUND: Heartburn (HB) and acid reflux (RF) in the nonpregnant population can cause nausea and vomiting; therefore, it is plausible that in women with nausea and vomiting of pregnancy (NVP), HB/RF may increase the severity of symptoms. OBJECTIVE: To determine whether HB/RF during pregnancy contribute to increased severity of NVP. METHODS: A prospectively collected cohort of women who were experiencing NVP and HB, RF or both (n=194) was Studied. The Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scale and its Well,being scale was used to compare the severity of the study cohort's symptoms. This cohort was compared with a group Of women experiencing NVP but no HB/RF (n=188). Multiple linear regression was used to control for the effects of confounding factors. RESULTS: Women with HB/RF reported higher PUQE scores (9.6 +/- 2.6) compared with controls (8.9 +/- 2.6) (P=0.02). Similarly, Well-being scores for women experiencing HB/RF were lower (4.3 +/- 2.1) compared with controls (4.9 +/- 2.0) (P=0.01). Multiple linear regression analysis demonstrated that increased PUQE scores (P=0.003) and decreased Well,being scores (P=0.005) were due to the presence of HB/RF as opposed to confounding factors such as pre-existing gastrointestinal conditions/symptoms, hyperemesis gravidarum in previous pregnancies and comorbidities. CONCLUSION: The present cohort Study is the first to demonstrate that HB/RF are associated with increased severity of NVP. Managing HB/RF may improve the severity of NVP.