Experience with ginger in the treatment of nausea and vomiting of pregnancy
Background: Nausea and vomiting of pregnancy are the most common symptoms of progressive gestation and occur in 70–80% of pregnant women. Nausea and vomiting of pregnancy are associated with certain adverse outcomes for the mother, fetus, and offspring, whereas their level has a significant negative impact on different aspects of women's quality of life, including working capacity, family relationships, - the ability to lead a usual social life and the willingness to become pregnant again.Khabarov S.V.
Objective: To study the efficacy of ginger extract in nausea and vomiting of pregnancy.
Materials and methods: The observational study included 94 women at 6 to 16 weeks’ gestation with mild to moderate nausea and/or vomiting of pregnancy. The patients’ quality of life and health were assessed in a questionnaire before, during, and after the end of a treatment cycle, by determining the socioeconomic status, habits, and lifestyle from the Sickness Impact Profile questionnaire and the severity of nausea and vomiting of pregnancy from the Pregnancy-Unique Quantification of Emesis and Nausea. The efficacy of the Preginor complex for nausea and vomiting of pregnancy was evaluated at the end of the cycle of its administration and compared with the baseline values.
Results: By the end of therapy with the complex, 37.2% of patients did not complain of nausea and vomiting and they did not require further administration of Preginor. Nausea and vomiting were assigned as mild in 55.3% of pregnant women. Only 7.5% of the women who participated in the study did not report any considerable positive changes in their health when taking the complex; they continued to have moderate nausea and vomiting with a lower symptom intensity, which improved the pregnant women’s general condition and quality of life. However, the number of these patients declined 4-fold. There was a 2.2-fold decrease in the mean total index of nausea and vomiting after a treatment cycle.
Conclusion: The intake of the non-pharmacological complex Preginor substantially relieves the symptoms of nausea and vomiting and improves their quality of life. In our opinion, the use of Preginor as a dietary supplement is promising and causes its wider clinical introduction.
Keywords
nausea
vomiting
pregnancy
hyperemesis gravidarum
аntiemetic agents
ginger
gingerols
Preginor
quality of life
References
- Liu C., Zhao G., Qiao D., Wang L., He Y., Zhao M. et al. Emerging progress in nausea and vomiting of pregnancy and hyperemesis gravidarum: challenges and opportunities. Front. Med. (Lausanne). 2022; 8: 809270. https://dx.doi.org/10.3389/fmed.2021.809270.
- Hu Y., Amoah A.N., Zhang H., Fu R., Qiu Y., Cao Y. et al. Effect of ginger in the treatment of nausea and vomiting compared with vitamin B6 and placebo during pregnancy: a meta-analysis. J. Matern. Fetal Neonatal Med. 2022 ; 35(1): 187-96. https://dx.doi.org/10.1080/14767058.2020.1712714.
- Wang H., Rolls E.T., Du X., Du J., Yang D., Li J. et al. Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children. BMC Med. 2020; 18(1): 228. https://dx.doi.org/10.1186/s12916-020-01701-y.
- Fiaschi L., Nelson-Piercy C., Deb S., King R., Tata L.J. Clinical management of nausea and vomiting in pregnancy and hyperemesis gravidarum across primary and secondary care: a population-based study. BJOG. 2019; 126(10): 1201-11. https://dx.doi.org/10.1111/1471-0528.15662.
- Koren G., Boskovic R., Hard M., Maltepe C., Navioz Y., Einarson A. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2002; 186(5, Suppl. Understanding): S228-31. https://dx.doi.org/10.1067/mob.2002.123054.
- Lacasse A., Rey E., Ferreira E., Morin C., Bérard A. Validity of a modified pregnancy-unique quantification of emesis and nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am. J. Obstet. Gynecol. 2008; 198(1): 71.e1-7. https://dx.doi.org/10.1016/j.ajog.2007.05.051.
- Hada A., Minatani M., Wakamatsu M., Koren G., Kitamura T. The pregnancy-unique quantification of emesis and nausea (PUQE-24): configural, measurement, and structural invariance between nulliparas and multiparas and across two measurement time points. Healthcare (Basel). 2021; 9(11): 1553. https://dx.doi.org/10.3390/healthcare9111553.
- Nausea and Vomiting of Pregnancy. The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin. Clinical management guidelines for obstetrician–gynecologists. Number 189. January 2018. Committee on practice bulletins-obstetrics. Obstet. Gynecol. 2018; 131(1): e15-30.
- Sarecka-Hujar B., Szulc-Musioł B. Herbal medicines-are they effective and safe during pregnancy? Pharmaceutics. 2022; 14(1): 171. https://dx.doi.org/10.3390/pharmaceutics14010171.
- Слизовский Г.В., Кужеливский И.И., Шикунова Я.В., Сигарева Ю.А. Опыт лечения раннего токсикоза беременных. Акушерство и гинекология. 2018; 10: 118-22. [Slizovsky G.V., Kuzhelivsky I.I., Shikunova Ya.V., Sigareva Yu.A. Experience in treating early toxicosis of pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (10): 118-22. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.10.118-122.
- Mao Q.Q., Xu X.Y., Cao S.Y., Gan R.Y., Corke H., Beta T., Li H.B. Bioactive compounds and bioactivities of ginger (Zingiber officinale Roscoe). Foods. 2019; 8(6): 185. https://dx.doi.org/10.3390/foods8060185.
- Anh N.H., Kim S.J., Long N.P., Min J.E., Yoon Y.C., Lee E.G. et al. Ginger on human health: A comprehensive systematic review of 109 randomized controlled trials. Nutrients. 2020; 12(1): 157. https://dx.doi.org/10.3390/nu12010157.
- Zhang M., Zhao R., Wang D., Wang L., Zhang Q., Wei. S. et al. Ginger (Zingiber officinale Rosc.) and its bioactive components are potential resources for health beneficial agents. Phytother. Res. 2021; 35(2): 711-42.https://dx.doi.org/10.1002/ptr.6858.
- Kousch A. Ginger. In: Miller J.P., Van Buiten C., eds. Superfoods. Food and health. Springer; 2022: 97-108. https://dx.doi.org/10.1007/978-3-030-93240-4_8.
- Токарева С.В., Хадарцев А.А. Энтеросорбция как метод лечения интоксикации и серотониновой недостаточности (краткий обзор отечественной литературы). Вестник новых медицинских технологий. Электронное издание. 2021; 15(3): Публикация 3-1. https://dx.doi.org/10.24412/2075-4094-2021-3-3-1. Available at: http://www.medtsu.tula.ru/VNMT/Bulletin/E2021-3/3-1.pdf Дата обращения 14.05.2021. [Tokareva S.V., Khadartsev A.A. Enterosorption as a method of treatment of intoxication and serotonin deficiency (a brief review of Russian literature). Vestnik novyh medicinskih tehnologij /Journal of New Medical Technologies. eEdition. 2021; 15(3): Publication 3-1. (in Russian)]. https://dx.doi.org/10.24412/2075-4094-2021-3-3-1.
- Royal College of Obstetricians and Gynaecologists. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum. RCOG Green-top Guideline No. 69, June 2016. 27р.
- Campbell K., Rowe H., Azzam H., Lane C.A. The management of nausea and vomiting of pregnancy. J. Obstet. Gynaecol. Can. 2016; 38(12): 1127-37. https://dx.doi.org/10.1016/j.jogc.2016.08.009.
- Lowe S.A., Bowyer L., Beech A., Robinson H., Armstrong G., Marnoch C., Grzeskowiak L. Guideline for the management of nausea and vomiting in pregnancy and hyperemesis gravidarum. Society of Obstetric Medicine of Australia and New Zealand (SOMANZ). The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. 2019. 30р.
- Abbas A.M. Is ginger really effective for the treatment of the first trimester nausea and vomiting? J. Matern. Fetal Neonatal Med. 2019; 32(10): 1748.https://dx.doi.org/10.1080/14767058.2017.1416082.
- Stanisiere J., Mousset P.Y., Lafay S. How safe is ginger rhizome for decreasing nausea and vomiting in women during early pregnancy? Foods. 2018; 7(4): 50. https://dx.doi.org/10.3390/foods7040050.
- Nurmi M., Rautava P., Gissler M., Vahlberg T., Polo-Kantola P. Recurrence patterns of hyperemesis gravidarum. Am. J. Obstet. Gynecol. 2018; 219(5): 469.e1-469.e10. https://dx.doi.org/10.1016/j.ajog.2018.08.018.
- Laitinen L., Nurmi M., Ellilä P., Rautava P., Koivisto M., Polo-Kantola P. Nausea and vomiting of pregnancy: associations with personal history of nausea and affected relatives. Arch. Gynecol. Obstet. 2020; 302(4): 947-55.https://dx.doi.org/10.1007/s00404-020-05683-3.
- Berrak Mizrak Sahin. Investigation of factors associated with nausea and vomiting in pregnant women. J. Health Sci. Med. 2021; 4(4): 457-61.https://dx.doi.org/10.32322/jhsm.924353.
- Zhang H., Wu S., Feng J., Liu Z. Risk factors of prolonged nausea and vomiting during pregnancy. Risk Manag. Healthc Policy. 2020; 13: 2645-54.https://dx.doi.org/10.2147/RMHP.S273791.
- Bazargani F., Iliadis S.I., Elenis E. Mode of conception in relation to nausea and vomiting of pregnancy: a nested matched cohort study in Sweden. Sci. Rep. 2021; 11(1): 9039. https://dx.doi.org/10.1038/s41598-021-88575-z .
- Громова О.А., Торшин И.Ю., Тетруашвили Н.К., Лиманова О.А. О новых тенденциях в нутрициальной поддержке беременности. Акушерство и гинекология. 2018; 1: 21-8. [Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Limanova O.A. About new trends in nutritional support of pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; 1: 21-8.(in Russian)]. https://dx.doi.org/10.18565/aig.2018.1.21-28.
- Дубровина С.О., Красильникова Л.В. Особенности диеты беременных. Акушерство и гинекология. 2018; 1: 135-40. [Dubrovina S.O., Krasil'nikova L.V. Features of the diet of pregnant women. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; 1: 135-40. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.1.135-140.
- Хабаров С.В., Денисова О.В. Гормоны репродуктивной оси: лабораторные методы оценки. Часть 2. Клиническая лабораторная диагностика: учебное пособие. Колмогоров И.А. (Новый формат). 2021. 123с. [Кhabarov S.V., Denisova O.V. Hormones of the reproductive axis: laboratory methods of evaluation. Part 2. Clinical and laboratory diagnostics: a textbook. IP Kolmogorov I.A. (Novyj format). 2021; 123 р.(in Russian)].
- Choi H.J., Bae Y.J., Choi J.S., Ahn H.K., An H.S., Hong D.S. et al. Evaluation of nausea and vomiting in pregnancy using the Pregnancy-Unique Quantification of Emesis and Nausea scale in Korea. Obstet. Gynecol. Sci. 2018; 61(1): 30-7. https://dx.doi.org/10.5468/ogs.2018.61.1.30.
- Хамошина М.Б., Епишкина-Минина А.А., Тулупова М.С., Яцышина Д.В. Тошнота и рвота беременных: стоит ли вмешиваться? StatusPraesens. Гинекология, акушерство, бесплодный брак. 2021; 4: 86-91. [Кhamoshina M.B., Epishkina-Minina A.A., Tulupova M.S., Yacyshina D.V. Nausea and vomiting of pregnant women: is it worth intervening? StatusPraesens. Gynecology, obstetrics, infertile marriage. 2021; 4(79): 86-91. (in Russian)].
- Heitmann K., Nordeng H., Havnen G.C., Solheimsnes A., Holst L. The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again – results from a cross-sectional study. BMC Pregnancy Childbirth. 2017; 17: 75.https://dx.doi.org/10.1186/s12884-017-1249-0.
- Iliadis S.I., Axfors C., Johansson S., Skalkidou A., Mulic-Lutvica A. Women with prolonged nausea in pregnancy have increased risk for depressive symptoms postpartum. Sci. Rep. 2018; 8(1): 15796. https://dx.doi.org/10.1038/s41598-018-33197-1.
- van Gelder M.M.H.J., Nordeng H. Antiemetic prescription fills in pregnancy: A drug utilization study among 762,437 pregnancies in Norway. Clin. Epidemiol. 2021; 13: 161-74. https://dx.doi.org/10.2147/CLEP.S287892.
- Smith J.A., Fox K.A, Clark Shannon M. Nausea and vomiting of pregnancy: treatment and outcome. Literature review current through; Apr 2022.
- Прегинор. Единый реестр свидетельств о государственной регистрации. Available at: https://portal.eaeunion.org/sites/odata/_layouts/15/portal.eec.registry.ui/directoryform.aspx?listid=0e3ead06-5475-466a-a340-6f69c01b5687&itemid=231#f=%D0%BF%D1%80%D0%B5%D0%B3%D0%B8%D0%BD%D0%BE%D1%80
Received 08.07.2022
Accepted 14.07.2022
About the Authors
Sergey V. Khabarov, Dr. Med. Sci., Merited Doctor of the Russian Federation, Associate Professor, Professor at the Department of Obstetrics and Gynecology, Medical Institute, Tula State University; Professor at the Department of Clinical Laboratory Diagnostics and Pathological Anatomy, Academy of Postgraduate Education of the FMBA, +7(916)726-51-26, s.v.habarov@mail.ru, https://orcid.org/0000-0002-1736-9408, SPIN-code: 1896-1300, Scopus AuthorID: 57220038210, AuthorID: 1025053,Researcher ID: ABB-2726-2021, 300028, Russia, Tula, Boldin str., 128.
Conflicts of interest: The author declares that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The investigation has been approved by the Ethics Committee of the Medical Institute, Tula State University.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Khabarov S.V. Experience with ginger in the treatment of nausea and vomiting of pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 7: 96-102 (in Russian)
https://dx.doi.org/10.18565/aig.2022.7.96-102