Barriers and challenges in hyperemesis gravidarum research

Nausea and occasional vomiting in early pregnancy (NVP) are common. When vomiting is severe or protracted it is referred to as hyperemesis gravidarum (HG). HG affects up to 3% of pregnancies and is characterised by weight loss, dehydration, electrolyte imbalance and the need of hospital admission. HG has significant consequences for maternal wellbeing, is associated with adverse birth outcomes and leads to major health care costs. Currently, HG research and patient care are affected by the lack of evidence regarding HG diagnosis, treatment options and long-term consequences. These problems are all addressed in this thesis, which includes studies on the potential of biomarkers for HG diagnosis and prediction of disease severity, the effectiveness of treatment with corticosteroids or early enteral tube feeding for maternal and perinatal outcomes and exploration of the association of HG and long-term adverse cardiometabolic health in offspring. Lastly, the need for consensus on HG definition and trial outcomes is addressed.