Maternal weight loss associated with hyperemesis gravidarum: A predictor of fetal outcome

Over a 5-year period in our center 64 patients were hospitalized with a diagnosis of hyperemesis gravidarum. Patients were classified into two groups to determine whether weight loss was an objective predictor of pregnancy outcome. Patients whose weight loss was >5% of their prepregnancy weight were classified as group A ( n = 30). Patients with nausea and vomiting of pregnancy but with maintenance of at least 95% of prepregnancy body weight were in group B ( n = 34). Infants in group A were significantly smaller with respect to average birth weight expressed as a percentile for gestational age: 38.11 percentile, versus 72.00 percentile for group B ( p < 0.025). Macrosomia (≥4000 gm) was significantly associated with group B (18% versus group A, 0%; p < 0.025). Growth retardation (≤10th percentile weight at birth) was significantly associated with group A (30% versus group B, 6%; p < 0.01). Three integumentary system abnormalities (3 of 30 cases) occurred in group A compared with none in group B. Although hyperemesis gravidarum has been viewed as a positive predictor, those patients who also demonstrate weight loss and electrolyte disturbance may be a distinct entity and at greater risk for growth retardation and fetal anomalies.