Nausea and vomiting of pregnancy in relation to fear of childbirth: Evidence from a Finnish cohort

INTRODUCTION: Nausea and vomiting of pregnancy (NVP) is a common disorder affecting most pregnant women. Previous studies have suggested associations between NVP and psychological pregnancy complications, whereas only a limited number of studies have explored a possible association with fear of childbirth (FOC). Shared biological underlying factors have been proposed, but the precise mechanisms remain poorly understood. The objective of our study was to explore the relationship between NVP and FOC. MATERIAL AND METHODS: Pregnant women (n = 2411) were recruited from maternity health care clinics in the Turku area, Finland. The severity of NVP was evaluated with the Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire, and the women were categorized into two groups: the no/mild NVP group (PUQE points 3-6, n = 963) and the moderate/severe NVP group (PUQE points 7-15, n = 1366). Data on FOC (International Statistical Classification of Diseases, 10th Revision [ICD-10] code O99.80) and maternal characteristics (age, body mass index, parity, marital status, employment status, and smoking) were drawn from the Finnish Medical Birth Register. The association between NVP and FOC was evaluated using logistic regression adjusted for maternal characteristics. RESULTS: The data of 2329 women were eligible for the analysis. Compared with the women in the no/mild NVP group, those in the moderate/severe NVP group were more likely to suffer from FOC (OR 1.69, 95% CI 1.11-2.58, p = 0.015). The difference between the groups remained after adjustment for maternal background factors (aOR 1.72, 95% CI 1.09-2.71, p = 0.019). CONCLUSIONS: We showed an association between more severe NVP and FOC. The evidence from our study implies that, beyond the physical manifestation, NVP may contribute to psychological distress and influence women's perception of childbirth. These findings highlight the importance of also addressing the psychological aspects of NVP in clinical care.