Clinical management of nausea and vomiting in pregnancy and hyperemesis gravidarum across primary and secondary care: a population‐based study

Objectives To assess how nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) are managed and treated across primary and secondary care. Design Population‐based pregnancy cohort. Setting Medical records (CPRD‐GOLD) from England. Population 417 028 pregnancies during 1998–2014. Methods Proportions of pregnancies with recorded NVP/HG diagnoses, primary care treatment, and hospital admissions were calculated. Multinomial logistic regression was employed to estimate adjusted relative risk ratios (aRRRs) with 99% confidence intervals (CIs) for the association between NVP/HG management paths and maternal characteristics. Main outcome measures NVP/HG diagnoses, treatments, and hospital admissions. Results Overall prevalence of clinically recorded NVP/HG was 9.1%: 2.1% had hospital admissions, 3.4% were treated with antiemetics in primary care only, and 3.6% had only recorded diagnoses. Hospital admissions and antiemetic prescribing increased continuously during 1998–2013 (trend P