Background: Glucocorticoids are usually used as third-line therapy for hyperemesis gravidarum (HG) with variable demonstrated efficacy. Theoretical risks include maternal infection and hyperglycaemia and obstetric and neonatal concerns of congenital malformation, intrauterine growth restriction and preterm labour; with limited data from large observational or randomised studies.
Aim: To compare maternal and pregnancy outcomes in women with HG treated with and without glucocorticoid therapy.
Methods: Electronic medical records were retrospectively reviewed between 01/01/2023 – 31/12/2024 to include all women who were diagnosed with HG and gave birth at a single tertiary hospital. Women were identified through their medication history, clinic appointments and antenatal records. Women were excluded if they were prescribed glucocorticoids for indications other than HG. Maternal demographics, treatment, obstetric and neonatal outcomes were compared.
Results: Overall, 109 women were documented to have HG. Symptom severity scores were reported in 76 women (70%). 13 women were prescribed glucocorticoids within the study period. These women had more severe HG and median duration of glucocorticoid therapy was 16 weeks (IQR 16-23.5). There were no other differences in maternal demographics between groups.
Two out of the 13 women receiving glucocorticoids required insulin therapy for hyperglycaemia (15.3%). No other differences in obstetric or neonatal outcomes were identified.
Conclusion: Further data is required to guide individualised counselling and management of women with severe HG who may benefit from glucocorticoid therapy.