Ketonuria is not associated with hyperemesis gravidarum disease severity.

Autor: Koot MH; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: m.h.koot@amsterdamumc.nl., Grooten IJ; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Post JAMV; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Bais JMJ; Department of Obstetrics and Gynaecology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Ris-Stalpers C; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Reproductive Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Naaktgeboren CA; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, The Netherlands., Niemeijer MN; Department of Obstetrics and Gynaecology, HMC Westeinde, The Hague, The Netherlands., Bremer HA; Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, Delft, The Netherlands., van der Ham DP; Department of Obstetrics and Gynecology, Martini Hospital, Groningen, The Netherlands., Heidema WM; Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands., Huisjes A; Department of Obstetrics and Gynecology, Gelre Hospital, Apeldoorn, The Netherlands., Kleiverda G; Department of Obstetrics and Gynecology, Flevo Hospital, Almere, The Netherlands., Kuppens SM; Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands., van Laar JOEH; Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands., Langenveld J; Department of Obstetrics and Gynecology, Zuyderland Hospital, Heerlen, The Netherlands., van der Made F; Department of Obstetrics and Gynecology, Franciscus Gasthuis, Rotterdam, The Netherlands., Papatsonis D; Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands., Pelinck MJ; Department of Obstetrics and Gynecology, Scheper Hospital, Emmen, The Netherlands., Pernet PJ; Department of Obstetrics and Gynecology, Spaarne Gasthuis, Haarlem, The Netherlands., van Rheenen-Flach L; Department of Obstetrics and Gynecology, OLVG, Amsterdam, The Netherlands., Rijnders RJ; Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Scheepers HCJ; Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands., Vogelvang TE; Department of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, The Netherlands., Mol BW; Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia., Roseboom TJ; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Painter RC; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2020 Nov; Vol. 254, pp. 315-320. Date of Electronic Publication: 2020 Aug 26.
DOI: 10.1016/j.ejogrb.2020.08.014
Abstrakt: Objective: To assess the association between ketonuria and hyperemesis gravidarum (HG) disease severity.
Study Design: We included pregnant women hospitalised for HG who participated in the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) trial and women who were eligible, chose not to be randomised and agreed to participate in the observational cohort. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation. The presence of ketonuria was not required for study entry. Ketonuria was measured at hospital admission with a dipstick, which distinguishes 5 categories: negative and 1+ through 4 + . The outcome measures were multiple measures of HG disease severity at different time points: 1) At hospital admission (study entry): severity of nausea and vomiting, quality of life and weight change compared to pre-pregnancy weight, 2) One week after hospital admission: severity of nausea and vomiting, quality of life and weight change compared to admission, 3) Duration of index hospital admission and readmission for HG at any time point RESULTS: 215 women where included. Ketonuria was not associated with severity of nausea and vomiting, quality of life or weight loss at hospital admission, nor was the degree of ketonuria at admission associated with any of the outcomes 1 week after hospital admission. The degree of ketonuria was also not associated with the number of readmissions. However, women with a higher degree of ketonuria had a statistically significant longer duration of hospital stay (per 1+ ketonuria, difference: 0.27 days, 95 % CI: 0.05 to 0.48).
Conclusions: There was no association between the degree of ketonuria at admission and severity of symptoms, quality of life, maternal weight loss, or number of readmissions, suggesting that ketonuria provides no information about disease severity or disease course. Despite this, women with a higher degree of ketonuria at admission were hospitalised for longer. This could suggest that health care professionals base length of hospital stay on the degree of ketonuria. Based on the lack of association between ketonuria and disease severity, we suggest it has no additional value in the clinical management of HG.
Competing Interests: Declaration of Competing Interest None declared. Completed disclosure of interests form available to view online as supporting information.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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