Objectives

To assess if there is any association between hyperemesis gravidarum (HG), psychological morbidity and infant bonding and to quantify any psychosocial consequences of HG DesignTwo-point prospective case control, multi-centre survey study with antenatal and postnatal data collection SettingThree London hospitalsParticipantsPregnant women at ≤ 12 completed weeks gestation recruited consecutively over two years. Women with HG were recruited at the time of admission; controls recruited from a low risk antenatal clinic. 106 women were recruited to the cases group and 108 to the control. Response rates at antenatal data collection were 87% and 85% in the cases and control groups respectively. Postnatally, the response rate was 90% in both groups. Primary and secondary outcome measuresPrimary outcomes were; psychological morbidity in the antenatal and postnatal periods, infant bonding in the postnatal period and psychosocial implications of HG. Secondary outcomes were the effects of severity and longevity of HG and assessment of correlation between EPDS scores and maternal-to-infant bonding scores. ResultsAntenatally, 49% of cases had probable depression compared to 6% of controls (OR 14.4 (5.29,39.44). Postnatally, 29% of cases had probable depression versus 7% of controls (OR 5.2(1.65,17.21). There was no direct association between HG and infant bonding. 53% of women in the HG group reported needing four or more weeks of sick leave compared to 2% in the control group (OR 60.5 (95% CI 8.4;2535.6)). ConclusionsLong lasting psychological morbidity associated with HG was evident. Significantly more women in the cases group sought help for mental health symptoms in the antenatal period, however very few were diagnosed with or treated for depression in pregnancy or referred to specialist perinatal mental health services. HG did not directly affect infant bonding. Women in the cases group required long periods off work, highlighting the socioeconomic impact of HG.