Features of nausea and vomiting in pregnancy as predictive factors of post-partum depression: a systematic review.

BACKGROUND

To investigate the association between nausea and vomiting during pregnancy (NVP), including hyperemesis gravidarum (HG), and postpartum depression (PPD), and to identify predictive symptoms of PPD to improve preventive care and follow-up.

METHODS

A systematic search was conducted in six databases from inception to June 25, 2024, using predefined keywords and MeSH terms related to PPD and pregnancy-related vomiting. Eligible studies included original research articles examining the association between PPD and NVP (any duration or severity, including HG). Articles were restricted to English or French. Diagnostic criteria for NVP and PPD had to be clearly specified. The systematic review followed PRISMA guidelines and was registered with PROSPERO (CRD42024508214). Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Two independent researchers conducted article screening, data extraction, and bias assessment.

RESULTS

Out of 355 identified articles, 18 (mainly prospective and retrospective cohort studies) were included. Analysis revealed a significantly increased risk of PPD in women with NVP, ranging from adjusted odds ratios (aORs) of 1.54 [95% CI 1.42-1.68] for mild NVP to 6.52 [95% CI 3.76-11.30] for severe NVP and 2.26 [95% CI 1.04-4.92] for persistent symptoms. These values represent the lowest and highest aORs reported in individual studies, not a pooled meta-analytic estimate. The association remained significant in large-scale studies after adjusting for confounders.

CONCLUSIONS

This review highlights the importance of monitoring the severity and duration of NVP during pregnancy. Identifying these symptoms should prompt systematic PPD screening, especially within the first 6 months postpartum, to facilitate timely intervention and improve maternal mental health outcomes.

TRIAL REGISTRATION: PROSPERO registration date April 30th 2024. PROSPERO registration number CRD42024508214.