Posted Tue, Jun, 07,2016
This author interview is by Dr Iris Grooten, of Academic Medical Center, Amsterdam. Dr Grooten's full paper, A systematic review and meta-analysis of the utility of corticosteroids in the treatment of hyperemesis gravidarum, is available for download in Nutrition and Metabolic Insights.
Please summarize for readers the content of your article.
We performed a systematic review and meta-analysis on the effectiveness of corticosteroids for hyperemesis gravidarum (HG). Corticosteroids are effective in reducing chemotherapy-induced nausea and vomiting. The use of corticosteroids for HG has been advocated. However, based on five small trials, there is currently insufficient evidence to support corticosteroid treatment for HG. A high quality trial is needed to answer whether corticosteroids, in addition to antiemetics, are useful in refractory HG.
How did you come to be involved in your area of study?
As a resident in Obstetrics and Gynaecology and PhD candidate , I am interested in the developmental origins of health and disease hypothesis (DOHaD) and the potential long-term consequences of HG. We therefore performed a randomized controlled trial studying the effectiveness of a nutritional intervention for HG (www.studies-obsgyn.nl/mother) . Although HG has great impact on maternal quality of life, few treatment options are available for these women.
What was previously known about the topic of your article?
Treatment options for HG are limited. Because single small trials have indicated some beneficial effects of corticosteroids for HG, this treatment option has been advocated.
How has your work in this area advanced understanding of the topic?
Meta-analysis of available data showed no effect of corticosteroids on readmission rate. This analysis included the largest study performed. 2 smaller studies found some beneficial effects. There was evidence of publication bias. Replication of positive findings in an adequately powered trial is needed before the use of corticosteroids should be implemented in clinical guidelines. The differential use of HG definition and reported outcomes limits the possibility of aggregated conclusions. Uniform definition and core outcomes would advance HG research.
What do you regard as being the most important aspect of the results reported in the article?
There is currently insufficient evidence to support CCS in the treatment of HG.
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