{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T18:44:05Z","timestamp":1778784245796,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Hyperemesis gravidarum (HG) is a condition that develops early in pregnancy, before 16\u202fweeks of gestation, and is characterized by severe nausea and\/or vomiting, inability to tolerate food and\/or beverages, and substantial impairment of daily activities. Hyperemesis gravidarum can have obvious maternal and fetal consequences. This study aimed to assess the prevalence of HG, investigate its associated electrolyte and hematologic disturbances, and identify risk factors among pregnant women in Aljouf, Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational case-control study was conducted using 200 medical records selected from a total of 9,090 records of pregnant women at the Maternity and Children Hospital in Aljouf, covering the period from November 2020 to November 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of hyperemesis gravidarum was 1.1% among the studied pregnant women. Patients diagnosed with hyperemesis gravidarum showed significantly lower body weight and BMI than controls. Nearly 48% of HG cases occurred in women aged 30\u201339\u202fyears, while 52% were in the first trimester. Furthermore, 36% of the affected women were primigravida, and 11% were pregnant with twins. Hypotension was observed in 35% of HG cases. Hyponatremia occurred in 29% of patients, hypokalemia in 21%, and hypochloremia in 24%. Hematological disturbances included increased Hb levels in 11% of cases, increased hematocrit in 12%, leukocytosis in 19%, and neutrophilia in 17% of the patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hypotension, electrolyte imbalance, and hematological disturbances are the primary consequences of HG. First-trimester pregnancy and low gestational age are the most important risk factors for HG. Strategies by healthcare centers and further research are needed to enhance the treatment, management, and prevention methods of HG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1703120","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:35:20Z","timestamp":1771828520000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of hyperemesis gravidarum and its associated electrolyte and hematologic disturbances in pregnant women"],"prefix":"10.3389","volume":"13","author":[{"given":"Heba Bassiony","family":"Ghanem","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaher Mustafa","family":"Hammoudeh","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Neonatology, El Sharq Hospital","place":["Fujairah, United Arab Emirates"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moaz","family":"Abulfaraj","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, King Abdulaziz University","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia Mahmoud Abdelmonem","family":"Elsherbini","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanaa Elfatih","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamila Ibrahim","family":"Algader","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghad Mohammed","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taif Yahya","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amirah Enad","family":"Alruwaili","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najd Budayri","family":"Alruwaili","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"El-Sherbiny","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, College of Medicine, AlMaarefa University","place":["Riyadh, Saudi Arabia"]},{"name":"Research Center, Deanship of Scientific Research and Post-Graduate Studies, AlMaarefa University","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Baker A.","family":"Alshaikh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maged","family":"Elshamy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Mahmoud Abdelfattah","family":"Abdelrahman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Mansoura University","place":["Mansoura, Egypt"]},{"name":"Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, King Abdulaziz University","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagwan Ahmed","family":"Bahgat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University","place":["Mansoura, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref1","first-page":"e171","article-title":"Quantifying the global rates of nausea and vomiting of pregnancy: a meta-analysis","volume":"20","author":"Einarson","year":"2013","journal-title":"J Popul Ther Clin Pharmacol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"231","DOI":"10.31083\/j.ceog4910231","article-title":"Demographic, clinical, and obstetrical characterization of women with hyperemesis gravidarum using a more restrictive diagnosis","volume":"49","author":"Galletta","year":"2022","journal-title":"Clin Exp Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ejogrb.2021.09.004","article-title":"The Windsor definition for hyperemesis gravidarum: a multistakeholder international consensus definition","volume":"266","author":"Jansen","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0281433","DOI":"10.1371\/journal.pone.0281433","article-title":"Proportion of hyperemesis gravidarum and associated factors among pregnant women admitted into the obstetrics ward at Akesta general hospital, north East Ethiopia","volume":"18","author":"Adane","year":"2023","journal-title":"PLoS One"},{"key":"ref5","first-page":"376","article-title":"Prevalence of hyperemesis gravidarum and associated factors among pregnant women at Jimma University medical center, south West Ethiopia: a cross-sectional study","volume":"3","author":"Segni","year":"2016","journal-title":"EC Gynaecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.ejogrb.2019.03.006","article-title":"Wernicke\u2019s encephalopathy in hyperemesis gravidarum: a systematic review","volume":"236","author":"Oudman","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1038\/s41572-019-0110-3","article-title":"Nausea and vomiting of pregnancy and hyperemesis gravidarum","volume":"5","author":"Fejzo","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"ref8","first-page":"4781","article-title":"The transforming growth factor-\u03b2 superfamily cytokine macrophage inhibitory cytokine-1 is present in high concentrations in the serum of pregnant women","volume":"85","author":"Moore","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1038\/s41586-023-06921-9","article-title":"GDF15 linked to maternal risk of nausea and vomiting during pregnancy","volume":"625","author":"Fejzo","year":"2024","journal-title":"Nature"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2407607","DOI":"10.1155\/2016\/2407607","article-title":"Hyperemesis gravidarum in undiagnosed Gitelman\u2019s syndrome","volume":"2016","author":"Acelajado","year":"2016","journal-title":"Case Rep Med"},{"key":"ref11","first-page":"483","article-title":"Clinico-biochemical profile of women with hyperemesis gravidarum admitted in a tertiary hospital","volume":"26","author":"Kabir","year":"2017","journal-title":"Mymensingh Med J"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1002\/ijgo.15760","article-title":"Pregnancy outcomes by hyperemesis gravidarum severity and time of diagnosis: a retrospective cohort study","volume":"167","author":"Porgador","year":"2024","journal-title":"Int J Gynecol Obstet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.jiph.2022.12.020","article-title":"Development of national framework for health status and health system performance indicators in Saudi Arabia","volume":"16","author":"Al-Ghamdi","year":"2023","journal-title":"J Infect Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"469.e1","DOI":"10.1016\/j.ajog.2018.08.018","article-title":"Recurrence patterns of hyperemesis gravidarum","volume":"219","author":"Nurmi","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref15","first-page":"27","article-title":"The sex ratio of pregnancies complicated by hospitalization for hyperemesis gravidarum","volume-title":"BJOG","author":"Schiff","year":"2004"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/s12884-023-05771-7","article-title":"Watermelon and dietary advice compared to dietary advice alone following hospitalization for hyperemesis gravidarum: a randomized controlled trial","volume":"23","author":"Tan","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1093\/eurpub\/ckn051","article-title":"Length of residence and risk of developing hyperemesis gravidarum among first-generation immigrants to Norway","volume":"18","author":"Vikanes","year":"2008","journal-title":"Eur J Pub Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.3109\/14767058.2013.851187","article-title":"The impact of total parenteral nutrition support on pregnancy outcome in women with hyperemesis gravidarum","volume":"27","author":"Peled","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"78","DOI":"10.3109\/0167482X.2012.666594","article-title":"Do immigration and acculturation have an impact on hyperemesis gravidarum? Results of a study in Berlin, Germany","volume":"33","author":"David","year":"2012","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1186\/s12905-023-02386-0","article-title":"Determinants of hyperemesis gravidarum among pregnant women attending antenatal care at public and private hospitals in Bahir Dar City, north-West Ethiopia, 2022: a multicenter unmatched case-control study","volume":"23","author":"Asrade","year":"2023","journal-title":"BMC Womens Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1016\/0002-9378(87)90126-8","article-title":"Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and their maternal factors: a seroepidemiologic study","volume":"156","author":"DePue","year":"1987","journal-title":"Am J Obstet Gynecol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1159\/000291833","article-title":"Pregnancy nausea related to women\u2019s obstetric and personal histories","volume":"43","author":"Gadsby","year":"1997","journal-title":"Gynecol Obstet Investig"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/1741-7015-8-46","article-title":"Managing hyperemesis gravidarum: a multimodal challenge","volume":"8","author":"Jueckstock","year":"2010","journal-title":"BMC Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/j.1479-828X.2009.01079.x","article-title":"Severe autonomic dysfunction complicated by hyperemesis gravidarum causing unstable blood pressure in pregnancy","volume":"49","author":"Salmon","year":"2009","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref25","first-page":"22","article-title":"Helicobacter pylori and hyperemesis gravidarum: continuous study (2)","volume":"8","author":"Nashaat","year":"2010","journal-title":"Nat Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1507\/endocrj.EJ18-0496","article-title":"Hyperemesis gravidarum followed by refeeding syndrome causes electrolyte abnormalities induced rhabdomyolysis and diabetes insipidus","volume":"66","author":"Kondo","year":"2019","journal-title":"Endocr J"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.33588\/rn.3011.99589","article-title":"Central pontine myelinolysis and pregnancy: a case report and review of literature","volume":"30","author":"Burneo","year":"2000","journal-title":"Rev Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"149","DOI":"10.4103\/JLP.JLP_151_18","article-title":"Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: a case\u2013control study","volume":"11","author":"\u00c7intesun","year":"2019","journal-title":"J Lab Phys"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1055\/s-0042-1743101","article-title":"Hematological parameters to predict the severity of hyperemesis gravidarum and ketonuria","volume":"44","author":"Aslan","year":"2022","journal-title":"Rev Bras Ginecol Obstet"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"315","DOI":"10.5603\/GP.a2017.0059","article-title":"Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case-control study","volume":"88","author":"Beyazit","year":"2017","journal-title":"Clin Exp Obstet Gynecol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"27","DOI":"10.4274\/eamr.galenos.2020.32448","article-title":"Inflammatory markers in hyperemesis gravidarum","volume":"37","author":"\u00d6zay","year":"2021","journal-title":"Eur Arch Med Res"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1703120\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:35:21Z","timestamp":1771828521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1703120\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":31,"alternative-id":["10.3389\/fmed.2026.1703120"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1703120","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"article-number":"1703120"}}