Early enteral tube feeding in optimizing treatment of hyperemesis gravidarum: the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial

被引：33

作者：

Grooten, Iris J. ^{[1
,2
,4
]}

Koot, Marjette H. ^{[1
,2
]}

van der Post, Joris A. M. ^{[1
]}

Bais, Joke M. J. ^{[4
]}

Ris-Stalpers, Carrie ^{[3
]}

Naaktgeboren, Christiana ^{[1
]}

Bremer, Henk A. ^{[5
]}

van der Ham, David P. ^{[6
]}

Heidema, Wieteke M. ^{[7
]}

Huisjes, Anjoke ^{[8
]}

Kleiverda, Gunilla ^{[9
]}

Kuppens, Simone ^{[10
]}

van Laar, Judith O. E. H. ^{[11
]}

Langenveld, Josje ^{[12
]}

van der Made, Flip ^{[13
]}

van Pampus, Marielle G. ^{[14
]}

Papatsonis, Dimitri ^{[15
]}

Pelinck, Marie-Jose ^{[16
]}

Pernet, Paula J. ^{[17
]}

van Rheenen, Leonie ^{[14
]}

Rijnders, Robbert J. ^{[18
]}

Scheepers, Hubertina C. J. ^{[19
]}

Vogelvang, Tatjana E. ^{[20
]}

Mol, Ben W. ^{[21
,22
]}

Roseboom, Tessa J. ^{[1
,2
]}

Painter, Rebecca C. ^{[1
]}

机构：

[1] Univ Amsterdam, Dept Obstet & Gynecol, Amsterdam, Netherlands

[2] Univ Amsterdam, Dept Clin Epidemiol Biostatist & Bioinformat, Amsterdam, Netherlands

[3] Univ Amsterdam, Acad Med Ctr, Lab Reprod Biol, Amsterdam, Netherlands

[4] Northwest Hosp Grp, Dept Obstet & Gynaecol, Alkmaar, Netherlands

[5] Reinier de Graaf Hosp, Dept Obstet & Gynecol, Delft, Netherlands

[6] Martini Hosp, Dept Obstet & Gynecol, Groningen, Netherlands

[7] Radboud Univ Nijmegen, Med Ctr, Dept Obstet & Gynecol, Nijmegen, Netherlands

[8] Gelre Hosp, Dept Obstet & Gynecol, Apeldoorn, Netherlands

[9] Flevo Hosp, Dept Obstet & Gynecol, Almere, Netherlands

[10] Catharina Hosp, Dept Obstet & Gynecol, Eindhoven, Netherlands

[11] Maxima Med Ctr, Dept Obstet & Gynecol, Veldhoven, Netherlands

[12] Zuyderland Hosp, Dept Obstet & Gynecol, Heerlen, Netherlands

[13] Franciscus Hosp, Dept Obstet & Gynecol, Rotterdam, Netherlands

[14] Onze Lieve Vrouwen Hosp, Dept Obstet & Gynecol, Amsterdam, Netherlands

[15] Amphia Hosp, Dept Obstet & Gynecol, Breda, Netherlands

[16] Scheper Hosp, Dept Obstet & Gynecol, Emmen, Netherlands

[17] Spaarne Hosp, Dept Obstet & Gynecol, Haarlem, Netherlands

[18] Jeroen Bosch Hosp, Dept Obstet & Gynecol, Shertogenbosch, Netherlands

[19] Maastricht Univ, Med Ctr, Dept Obstet & Gynecol, Maastricht, Netherlands

[20] Diakonessen Hosp, Dept Obstet & Gynecol, Utrecht, Netherlands

[21] Univ Adelaide, Sch Pediat & Reprod Hlth, Robinson Inst, Adelaide, SA, Australia

[22] South Australian Hlth & Med Res Inst, Adelaide, SA, Australia

来源：

AMERICAN JOURNAL OF CLINICAL NUTRITION | 2017年 / 106卷 / 03期

关键词：

nausea and vomiting in pregnancy; morning sickness; enteral nutrition; intravenous rehydration; weight loss; pregnancy outcome; PREGNANCY OUTCOMES; NAUSEA; NUTRITION; LIFE; COHORT; DISEASE;

D O I：

10.3945/ajcn.117.158931

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background: Hyperemesis gravidarum (HG) leads to dehydration, poor nutritional intake, and weight loss. HG has been associated with adverse pregnancy outcomes such as low birth weight. Information about the potential effectiveness of treatments for HG is limited. Objective: We hypothesized that in women with HG, early enteral tube feeding in addition to standard care improves birth weight. Design: We performed a multicenter, open-label randomized controlled trial [Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER)] in 19 hospitals in the Netherlands. A total of 116 women hospitalized for HG between 5 and 20 wk of gestation were randomly allocated to enteral tube feeding for >= 7 d in addition to standard care with intravenous rehydration and antiemetic treatment or to standard care alone. Women were encouraged to continue tube feeding at home. On the basis of our power calculation, a sample size of 120 women was anticipated. Analyses were performed according to the intention-to-treat principle. Results: Between October 2014 and March 2016 we randomly allocated 59 women to enteral tube feeding and 57 women to standard care. The mean 6 SD birth weight was 3160 +/- 770 g in the enteral tube feeding group compared with 3200 +/- 680 g in the standard care group (mean difference: -40 g, 95% CI: -230, 310 g). Secondary outcomes, including maternal weight gain, duration of hospital stay, readmission rate, nausea and vomiting symptoms, decrease in quality of life, psychological distress, prematurity, and small-for-gestationalage, also were comparable. Of the women allocated to enteral tube feeding, 28 (47%) were treated according to protocol. Enteral tube feeding was discontinued within 7 d of placement in the remaining women, primarily because of its adverse effects (34%). Conclusions: In women with HG, early enteral tube feeding does not improve birth weight or secondary outcomes. Many women discontinued tube feeding because of discomfort, suggesting that it is poorly tolerated as an early routine treatment of HG. This trial was registered at www.trialregister.nl as NTR4197.

引用

页码：812 / 820

页数：9

共 37 条

[1]

American College of Obstetrics and Gynecologists, 2016, ACOG GUID NAUS VOM P

[2] FETAL NUTRITION AND CARDIOVASCULAR-DISEASE IN ADULT LIFE [J].

BARKER, DJP ;

GLUCKMAN, PD ;

GODFREY, KM ;

HARDING, JE ;

OWENS, JA ;

ROBINSON, JS .

LANCET, 1993, 341 (8850) :938-941

[3] Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and Nausea) Identifies Patients with Hyperemesis Gravidarum and Poor Nutritional Intake: A Prospective Cohort Validation Study [J].

Birkeland, Elisabeth ;

Stokke, Guro ;

Tangvik, Randi J. ;

Torkildsen, Erik A. ;

Boateng, Jane ;

Wollen, Anne L. ;

Albrechtsen, Susanne ;

Flaatten, Hans ;

Trovik, Jone .

PLOS ONE, 2015, 10 (04)

[4]

Boelig RC, 2016, SYST REV

[5] Outcomes of pregnancies complicated by hyperemesis gravidarum [J].

Dodds, Linda ;

Fell, Deshayne B. ;

Joseph, K. S. ;

Allen, Victoria M. ;

Butler, Blair .

OBSTETRICS AND GYNECOLOGY, 2006, 107 (02) :285-292

[6] Nausea and Vomiting of Pregnancy: Using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) Scale [J].

Ebrahimi, Neda ;

Maltepe, Caroline ;

Bournissen, Facundo Garcia ;

Koren, Gideon .

JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA, 2009, 31 (09) :803-807

[7] Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes [J].

Ehrenberg, HM ;

Dierker, L ;

Milluzzi, C ;

Mercer, BM .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2003, 189 (06) :1726-1730

[8] Early nasogastric tube feeding in optimising treatment for hyperemesis gravidarum: the MOTHER randomised controlled trial (Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding) [J].

Grooten, Iris J. ;

Mol, Ben W. ;

van der Post, Joris A. M. ;

Ris-Stalpers, Carrie ;

Kok, Marjolein ;

Bais, Joke M. J. ;

Bax, Caroline J. ;

Duvekot, Johannes J. ;

Bremer, Henk A. ;

Porath, Martina M. ;

Heidema, Wieteke M. ;

Bloemenkamp, Kitty W. M. ;

Scheepers, Hubertina C. J. ;

Franssen, Maureen T. M. ;

Oudijk, Martijn A. ;

Roseboom, Tessa J. ;

Painter, Rebecca C. .

BMC PREGNANCY AND CHILDBIRTH, 2016, 16

[9]

Gulley R M, 1993, Nutr Clin Pract, V8, P33, DOI 10.1177/011542659300800133

[10] Hyperemesis gravidarum and pregnancy outcomes [J].

Hastoy, A. ;

Tran, P. Lien ;

Lakestani, O. ;

Barau, G. ;

Gerardin, P. ;

Boukerrou, M. .

JOURNAL DE GYNECOLOGIE OBSTETRIQUE ET BIOLOGIE DE LA REPRODUCTION, 2015, 44 (02) :154-163

← 1 2 3 4 →