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Systematic review
Measures of depression and anxiety in women with hyperemesis gravidarum are flawed
  1. Marlena Schoenberg Fejzo
  1. Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
  1. Correspondence to Dr Marlena Schoenberg Fejzo, Department of Medicine, University of Californi, Los Angeles, 5535 MRL, 675 Charles, Los Angeles 90095 CA, USA; mfejzo{at}

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Commentary on: Mitchell-Jones N, Gallos I, Farren J, et al. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta-analysis. BJOG. 2017;124:20-30.

Implications for practice and research

  • Suggesting hyperemesis gravidarum (HG) is psychological can be offensive to women experiencing HG. Caregivers should be sensitive to patient needs for supportive care.

  • New methods of psychological support should be tested in HG patients, such as phone counselling/texting the bedridden patient.

  • Current measures of anxiety and depression are not applicable to HG. A new tool specific to HG is necessary.


Nausea and vomiting in pregnancy (NVP) is common, occurring in up to 91% of pregnant women. The most severe form, hyperemesis gravidarum (HG), occurs in as many as 2% of pregnant women. HG has been associated with significant psychological morbidity, and Mitchell-Jones et al provide the first systematic review and meta-analysis of the published data on depression and anxiety in pregnancies …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.