A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy

Nicole P. Yost, Donald D. McIntire, Frank H. Wians, Susan M. Ramin, Jody A. Balko, Kenneth J. Leveno

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE: Hyperemesis gravidarum, a severe form of nausea and vomiting due to pregnancy for which there is no proven pharmacological treatment, is the third leading cause for hospitalization during pregnancy. Corticosteroids are commonly used for the treatment of nausea and vomiting due to cancer chemotherapy-induced emesis and might prove useful in hyperemesis gravidarum. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in 126 women who previously had not responded to outpatient therapy for hyperemesis gravidarum during the first half of pregnancy. Intravenous methylprednisolone (125 mg) was followed by an oral prednisone taper (40 mg for 1 day, 20 mg for 3 days, 10 mg for 3 days, 5 mg for 7 days) versus an identical-appearing placebo regimen. All women also received promethazine 25 mg and metoclopramide 10 mg intravenously every 6 hours for 24 hours, followed by the same regimen administered orally as needed until discharge. The primary study outcome was the number of women requiring rehospitalization for hyperemesis gravidarum. RESULTS: A total of 110 women delivered at our hospital and had pregnancy outcomes available for analysis; 56 were randomized to corticosteroids and 54 were administered placebo. Nineteen women in each study group required rehospitalization (34% versus 35%, P = .89, for corticosteroids versus placebo, respectively). CONCLUSION: The addition of parenteral and oral corticosteroids to the treatment of women with hyperemesis gravidarum did not reduce the need for rehospitalization later in pregnancy.

Original languageEnglish (US)
Pages (from-to)1250-1254
Number of pages5
JournalObstetrics and Gynecology
Volume102
Issue number6
DOIs
StatePublished - Dec 2003

Fingerprint

Hyperemesis Gravidarum
Adrenal Cortex Hormones
Randomized Controlled Trials
Placebos
Pregnancy
Vomiting
Nausea
Promethazine
Metoclopramide
Methylprednisolone
Therapeutics
Pregnancy Outcome
Prednisone
Hospitalization
Outpatients
Outcome Assessment (Health Care)
Pharmacology
Drug Therapy
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy. / Yost, Nicole P.; McIntire, Donald D.; Wians, Frank H.; Ramin, Susan M.; Balko, Jody A.; Leveno, Kenneth J.

In: Obstetrics and Gynecology, Vol. 102, No. 6, 12.2003, p. 1250-1254.

Research output: Contribution to journalArticle

Yost, Nicole P. ; McIntire, Donald D. ; Wians, Frank H. ; Ramin, Susan M. ; Balko, Jody A. ; Leveno, Kenneth J. / A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy. In: Obstetrics and Gynecology. 2003 ; Vol. 102, No. 6. pp. 1250-1254.
@article{ff2c87e48a95463b81d35452a8484be0,
title = "A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy",
abstract = "OBJECTIVE: Hyperemesis gravidarum, a severe form of nausea and vomiting due to pregnancy for which there is no proven pharmacological treatment, is the third leading cause for hospitalization during pregnancy. Corticosteroids are commonly used for the treatment of nausea and vomiting due to cancer chemotherapy-induced emesis and might prove useful in hyperemesis gravidarum. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in 126 women who previously had not responded to outpatient therapy for hyperemesis gravidarum during the first half of pregnancy. Intravenous methylprednisolone (125 mg) was followed by an oral prednisone taper (40 mg for 1 day, 20 mg for 3 days, 10 mg for 3 days, 5 mg for 7 days) versus an identical-appearing placebo regimen. All women also received promethazine 25 mg and metoclopramide 10 mg intravenously every 6 hours for 24 hours, followed by the same regimen administered orally as needed until discharge. The primary study outcome was the number of women requiring rehospitalization for hyperemesis gravidarum. RESULTS: A total of 110 women delivered at our hospital and had pregnancy outcomes available for analysis; 56 were randomized to corticosteroids and 54 were administered placebo. Nineteen women in each study group required rehospitalization (34{\%} versus 35{\%}, P = .89, for corticosteroids versus placebo, respectively). CONCLUSION: The addition of parenteral and oral corticosteroids to the treatment of women with hyperemesis gravidarum did not reduce the need for rehospitalization later in pregnancy.",
author = "Yost, {Nicole P.} and McIntire, {Donald D.} and Wians, {Frank H.} and Ramin, {Susan M.} and Balko, {Jody A.} and Leveno, {Kenneth J.}",
year = "2003",
month = "12",
doi = "10.1016/j.obstetgynecol.2003.08.013",
language = "English (US)",
volume = "102",
pages = "1250--1254",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy

AU - Yost, Nicole P.

AU - McIntire, Donald D.

AU - Wians, Frank H.

AU - Ramin, Susan M.

AU - Balko, Jody A.

AU - Leveno, Kenneth J.

PY - 2003/12

Y1 - 2003/12

N2 - OBJECTIVE: Hyperemesis gravidarum, a severe form of nausea and vomiting due to pregnancy for which there is no proven pharmacological treatment, is the third leading cause for hospitalization during pregnancy. Corticosteroids are commonly used for the treatment of nausea and vomiting due to cancer chemotherapy-induced emesis and might prove useful in hyperemesis gravidarum. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in 126 women who previously had not responded to outpatient therapy for hyperemesis gravidarum during the first half of pregnancy. Intravenous methylprednisolone (125 mg) was followed by an oral prednisone taper (40 mg for 1 day, 20 mg for 3 days, 10 mg for 3 days, 5 mg for 7 days) versus an identical-appearing placebo regimen. All women also received promethazine 25 mg and metoclopramide 10 mg intravenously every 6 hours for 24 hours, followed by the same regimen administered orally as needed until discharge. The primary study outcome was the number of women requiring rehospitalization for hyperemesis gravidarum. RESULTS: A total of 110 women delivered at our hospital and had pregnancy outcomes available for analysis; 56 were randomized to corticosteroids and 54 were administered placebo. Nineteen women in each study group required rehospitalization (34% versus 35%, P = .89, for corticosteroids versus placebo, respectively). CONCLUSION: The addition of parenteral and oral corticosteroids to the treatment of women with hyperemesis gravidarum did not reduce the need for rehospitalization later in pregnancy.

AB - OBJECTIVE: Hyperemesis gravidarum, a severe form of nausea and vomiting due to pregnancy for which there is no proven pharmacological treatment, is the third leading cause for hospitalization during pregnancy. Corticosteroids are commonly used for the treatment of nausea and vomiting due to cancer chemotherapy-induced emesis and might prove useful in hyperemesis gravidarum. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in 126 women who previously had not responded to outpatient therapy for hyperemesis gravidarum during the first half of pregnancy. Intravenous methylprednisolone (125 mg) was followed by an oral prednisone taper (40 mg for 1 day, 20 mg for 3 days, 10 mg for 3 days, 5 mg for 7 days) versus an identical-appearing placebo regimen. All women also received promethazine 25 mg and metoclopramide 10 mg intravenously every 6 hours for 24 hours, followed by the same regimen administered orally as needed until discharge. The primary study outcome was the number of women requiring rehospitalization for hyperemesis gravidarum. RESULTS: A total of 110 women delivered at our hospital and had pregnancy outcomes available for analysis; 56 were randomized to corticosteroids and 54 were administered placebo. Nineteen women in each study group required rehospitalization (34% versus 35%, P = .89, for corticosteroids versus placebo, respectively). CONCLUSION: The addition of parenteral and oral corticosteroids to the treatment of women with hyperemesis gravidarum did not reduce the need for rehospitalization later in pregnancy.

UR - http://www.scopus.com/inward/record.url?scp=0345549601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0345549601&partnerID=8YFLogxK

U2 - 10.1016/j.obstetgynecol.2003.08.013

DO - 10.1016/j.obstetgynecol.2003.08.013

M3 - Article

C2 - 14662211

AN - SCOPUS:0345549601

VL - 102

SP - 1250

EP - 1254

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 6

ER -