Early enteral tube feeding does not improve birth weight in women with hyperemesis gravidarum
Early enteral tube feeding neither increases birth weight nor improves secondary outcomes in women with hyperemesis gravidarum (HG), a recent study has found. Discomfort is accounted for the discontinuation of tube feeding, which suggests that it is poorly tolerated as an early routine treatment of HG.
A multicentre, open-label randomized controlled trial was conducted in 19 hospitals in the Netherlands. A total of 116 women hospitalized for HG between 5 and 20 weeks of gestation were randomly assigned to either enteral tube feeding (n=59) for ≥7 days in addition to standard care with intravenous rehydration and antiemetic treatment or to standard care alone (n=57).
Researchers encouraged all participants to continue tube feeding at home. A sample size of 120 women was expected based on power calculation. Analyses were performed according to the intention-to-treat principle.
The enteral tube feeding group had a mean±SD birth weight of 3,160±770 g while the standard care group had 3,200±680 g (mean difference, ‒40 g; 95 percent CI, ‒230 to 310 g). Both groups also showed similar secondary outcomes, including maternal weight gain, duration of hospital stay, readmission rate, nausea and vomiting symptoms, decrease in quality of life, psychological distress, prematurity, and small-for-gestational-age.
Forty-seven percent (n=28) of women in the enteral tube feeding group were treated according to protocol. Enteral feeding was stopped within 7 days of placement in the remaining participants due to its adverse effects (34 Percent).
HG leads to dehydration, poor nutritional intake and weight loss, and is associated with adverse pregnancy outcomes such as low birth weight, according to researchers.