Nothing much works for morning sickness, study finds

LOS ANGELES — For many women, morning sickness can be one of the most miserable parts of pregnancy. Unfortunately, new research reported today suggests that there is little women can do other than grin and bear it, since there appear to be no effective treatments.

The pharmaceutical industry once weighed in on the issue heavily, with the result being the introduction of the now-notorious thalidomide, which caused severe birth defects in a large number of infants. That episode led to increased requirements for safety screening of drugs before they are marketed and led to the still-prevalent consensus that it is generally not safe for women to take drugs during pregnancy, especially in the first trimester, when morning sickness is at its worst.

That has led many women to try alternative treatments, including sugar solutions, ginger, vitamin B6, acupressure and acupuncture. Unfortunately, there is little evidence that any of them are effective, Dr. Anne Matthews of the School of Nursing at Ireland’s Dublin City University reported Wednesday in the Cochrane Library, a prestigious source of research on the effectiveness of medical treatments.

As many as 85 percent of pregnant women experience nausea, and half of those endure actual vomiting. The cause is unknown, but researchers suspect hormonal imbalances. About 1 in 200 suffers so severely that she cannot keep any food or liquids down, a condition known as hyperemesis gravidarum. It requires medical treatment and can cause blood clots and damage to the infant. On the plus side, a 2007 study found that women who suffer morning sickness are less likely to develop breast cancer.

Matthews and her colleagues reviewed 27 clinical trials involving 4,041 pregnant women who were as much as 20 weeks pregnant. In six studies of acupuncture and two of acupressure — in which pressure is applied to acupuncture sites rather than needles — they found no benefit. One study of acustimulation, in which a small electric current is applied through the needles, found some benefit over three weeks. There was also very little evidence to support the benefits of ginger (which actually made many women sick), vitamin B6, antihistamines and anti-vomiting drugs. The anti-vomiting drugs induced sleepiness in recipients.

“A number of the studies we looked at appeared to show benefits, but in general the results were inconsistent and it was difficult to draw firm conclusions about any one treatment in particular,” Matthews said in a statement. “We were also unable to obtain much information about whether these treatments are actually making a difference in women’s quality of life.”

The best bet for pregnant women experiencing morning sickness, according to most experts: Get plenty of rest, drink a little at a time but often to prevent dehydration, and eat small servings of bland food such as toast and crackers. Also, avoid strong smells; eating food cold rather than hot can minimize odors that cause nausea.

Los Angeles Times: www.latimes.com

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