Hyperemesis Gravidarum Tied to Postpartum Depression, Eating Disorders, and Reduced Pregnancy Termination Risk: Study

A new study published in the journal of The Lancet Obstetrics, Gynaecology and Women’s Health severe nausea and vomiting in pregnancy (hyperemesis gravidarum) is associated with higher risks of postpartum depression, eating disorders, and other neuropsychiatric issues. Interestingly, the risk of pregnancy termination was reduced in this group.

The research used anonymized electronic medical records from the TriNetX network, and analyzed data from over 476,000 pregnant women across 18 countries between January 2010 and April 2025. Of these, women who had been clinically diagnosed with hyperemesis gravidarum (ICD-10 code O21) were compared to matched controls.

This research tracked 24 possible mental health outcomes, ranging from depression and postpartum depression to eating disorders, substance use, and suicidal behaviors. The findings suggest that hyperemesis gravidarum was linked to a significantly higher relative risk for 18 of the 24 outcomes studied.

Women with the condition were more than twice as likely to experience Wernicke’s encephalopathy, caused by vitamin deficiency and refeeding syndrome, that can occur during nutritional rehabilitation. Postpartum depression showed a 2.7-fold increase in risk, while eating disorders were twice as likely when compared to the control group. Prescriptions for antipsychotic medications were also more than doubled.

This study found no significant associations between hyperemesis gravidarum and non-affective psychoses, bipolar disorder without psychosis, intentional self-harm, or suicide attempts. Also, the risk of elective termination of pregnancy was reduced among women suffering from the condition, with a relative risk of 0.77.

The findings illuminate the complex relationship between the physical severity of hyperemesis gravidarum and its psychiatric consequences. This study observed that women with more severe forms of the illness involving metabolic disturbances appeared to have a reduced risk of depression compared to those with milder forms, which reflects the differences in healthcare engagement. Women with severe cases may receive more intensive medical attention and mental health monitoring, which could mitigate some psychiatric risks.

This work highlights the urgent need for tailored medical and psychological support for women experiencing hyperemesis gravidarum. Integrating mental health care into routine management of the condition could substantially improve outcomes for mothers and their families. Overall, these results reinforce the idea that maternal health is not only a physical concern but also a critical mental health priority.

Source:

Morrin, H., Abdel Bari, Y. A., Lynch-Kelly, K., Hafeez, D., Asan, L., Edwards, M. J., Seneviratne, G., & Pollak, T. A. (2025). Neuropsychiatric and mental health outcomes in hyperemesis gravidarum: a retrospective cohort study. The Lancet Obstetrics, Gynaecology, & Women’s Health. https://doi.org/10.1016/j.lanogw.2025.100023