The Nutritional Online sUrvey for pRegnancy Induced Sickness & Hyperemesis (NOURISH) study: results from the first trimester

Background:Hyperemesis gravidarum (HG) is severe pregnancy sickness,often leading to dehydration, weight loss and electrolyte disturbances. Little isknown about nutritional intake and its consequences in those affected. Theaim of this study was to explore thefirst trimester nutritional intake andclinical characteristics in those with severe sickness.Method:Recruitment was via the social media accounts of national pregnancycharities. The eligibility criteria were as follows: between 6 and 11 weekspregnant, age≥18 years and residing in the UK. Participants completed a self‐report online questionnaire including the Pregnancy Unique Quantification ofEmesis 24 (PUQE24) score and a 3‐day online diet diary. Groups werecompared by PUQE24 categories. Nutritional intakes were compared todietary reference values.Results:One hundred sixty‐six participants took part in the study: 36categorised with mild, 109 with moderate and 21 with severe symptoms at amedian gestation of 8.1 (interquartile range [IQR] 3) weeks. Those in thesevere category had significantly higher weight loss (3.0 kg, IQR 3.5) than themild category (0.0 kg, IQR 0.9). In those who completed the diet diary(n= 70), intakes of energy, carbohydrate, protein, fat,fibre, calcium, iron,zinc, thiamine, riboflavin, folate and vitamin C were all significantly lower inthe severe category (p< 0.05). The severe group consumed only 39.5% and41.6% of energy and protein needs, respectively, and were more likely to stoptaking micronutrient supplements (p< 0.05).Conclusion:Nutritional and supplement intake in those with severe pregnancysickness was poor; however, intake across all participants was suboptimal.Future research should investigate how to improve nutritional intake acrossall categories of pregnancy sickness.