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Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

Birkeland E, Stokke G, Tangvik RJ, Torkildsen EA, Boateng J, Wollen AL, Albrechtsen S, Flaatten H, Trovik J - PLoS ONE (2015)

Bottom Line: PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001).At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values).PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

View Article: PubMed Central - PubMed

Affiliation: Dpt. Clinical Science, University of Bergen, Bergen, Norway.

ABSTRACT

Objective: The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake.

Design: A prospective cohort validation study.

Setting: Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway.

Sample: 38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers.

Methods: Data were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to 15) and registered prospectively 24-hours nutritional intake by a food list form.

Main outcome measures: Differences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls.

Results: Hyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, p<0.001) otherwise groups were similar regarding pre-pregnant BMI, age, gravidity, and inclusion weight. Compared to controls, hyperemesis patients had significant higher PUQE-score (median 13; 95% CI 11-14 vs. 7; 95% CI 4-8), lower QOL (median score 3; 95% CI 2-4 vs. 6; 95% CI 4.5-8) and lower nutritional intake (energy intake median 990 kcal/24 hours; 95% CI 709-1233 vs. 1652; 95% CI 1558-1880 all p<0.001). PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001). At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values).

Conclusion: PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

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Related in: MedlinePlus

PUQE-24*-score in relation to gestational length for HG^ patients (n = 38) and controls (n = 31).*Pregnancy-Unique Quantification of Emesis and nausea. ^Hyperemesis Gravidarum.
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pone.0119962.g004: PUQE-24*-score in relation to gestational length for HG^ patients (n = 38) and controls (n = 31).*Pregnancy-Unique Quantification of Emesis and nausea. ^Hyperemesis Gravidarum.

Mentions: Patients had significantly higher scores in each of the three PUQE questions compared to controls as presented in Table 2. At inclusion the median PUQE-score was 13 in the HG group (95% CI 11–14, range 5–15) while the healthy pregnant women had a median of 7 (95% CI 5–8, range 3–13 p <0.001 Mann-Whitney tests), Fig. 3 and S2 Table. As illustrated in Fig. 4, displaying the relation between gestational age and PUQE-score, the two groups had distinct different PUQE-values across the age span investigated. Patients had high PUQE-scores irrespective of gestational length at inclusion while the control group demonstrated decreasing PUQE-scores with higher gestational length. Performing linear regression including the interaction of gestational length and group (hyperemesis group*controls), the overall adjusted model fit was R2 = 0.54. The interaction term (gestational age* patients vs. controls) was significant with p = 0.013, demonstrating the different effect of gestational age for the two cohorts included in this study.


Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

Birkeland E, Stokke G, Tangvik RJ, Torkildsen EA, Boateng J, Wollen AL, Albrechtsen S, Flaatten H, Trovik J - PLoS ONE (2015)

PUQE-24*-score in relation to gestational length for HG^ patients (n = 38) and controls (n = 31).*Pregnancy-Unique Quantification of Emesis and nausea. ^Hyperemesis Gravidarum.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4382206&req=5

pone.0119962.g004: PUQE-24*-score in relation to gestational length for HG^ patients (n = 38) and controls (n = 31).*Pregnancy-Unique Quantification of Emesis and nausea. ^Hyperemesis Gravidarum.
Mentions: Patients had significantly higher scores in each of the three PUQE questions compared to controls as presented in Table 2. At inclusion the median PUQE-score was 13 in the HG group (95% CI 11–14, range 5–15) while the healthy pregnant women had a median of 7 (95% CI 5–8, range 3–13 p <0.001 Mann-Whitney tests), Fig. 3 and S2 Table. As illustrated in Fig. 4, displaying the relation between gestational age and PUQE-score, the two groups had distinct different PUQE-values across the age span investigated. Patients had high PUQE-scores irrespective of gestational length at inclusion while the control group demonstrated decreasing PUQE-scores with higher gestational length. Performing linear regression including the interaction of gestational length and group (hyperemesis group*controls), the overall adjusted model fit was R2 = 0.54. The interaction term (gestational age* patients vs. controls) was significant with p = 0.013, demonstrating the different effect of gestational age for the two cohorts included in this study.

Bottom Line: PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001).At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values).PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

View Article: PubMed Central - PubMed

Affiliation: Dpt. Clinical Science, University of Bergen, Bergen, Norway.

ABSTRACT

Objective: The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake.

Design: A prospective cohort validation study.

Setting: Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway.

Sample: 38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers.

Methods: Data were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to 15) and registered prospectively 24-hours nutritional intake by a food list form.

Main outcome measures: Differences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls.

Results: Hyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, p<0.001) otherwise groups were similar regarding pre-pregnant BMI, age, gravidity, and inclusion weight. Compared to controls, hyperemesis patients had significant higher PUQE-score (median 13; 95% CI 11-14 vs. 7; 95% CI 4-8), lower QOL (median score 3; 95% CI 2-4 vs. 6; 95% CI 4.5-8) and lower nutritional intake (energy intake median 990 kcal/24 hours; 95% CI 709-1233 vs. 1652; 95% CI 1558-1880 all p<0.001). PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001). At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values).

Conclusion: PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

Show MeSH
Related in: MedlinePlus