{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:38Z","timestamp":1779951758243,"version":"3.53.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Analyze the trends and utilization patterns of medicine for hyperemesis gravidarum (HG) in nine Chinese cities over the past 6\u00a0years to provide a reference for clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The prescription data of drugs for patients diagnosed with HG from 2019\u20132024 were obtained from the Hospital Prescription Analysis Cooperation Project database of the Hospital Pharmacy Professional Committee of Chinese Pharmaceutical Association. A cross-sectional analysis was then performed of demographic characteristics, medication types, defined daily doses (DDDs), defined daily costs (DDC), combination therapy and comorbidities for HG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 9097 patients diagnosed with HG, involving 12,505 prescriptions, with a mean age of 29.97 \u00b1 4.35 years. The number of patients in new first-tier cities (Chengdu, Hangzhou, Shenyang, Zhengzhou) exhibited a significant increase. The proportion of advanced maternal age and \u226516 weeks patients has significantly increased. Vitamin B6, metoclopramide, omeprazole, hydrated magnesium hydroxide, and aluminum ranked highest in terms of DDDs. 87% of patients required hospitalization, where combination therapy was commonly observed, predominantly antiemetics combined with antacids\/acid reducers. Total prescription costs and\n                      <jats:italic>per capita<\/jats:italic>\n                      costs decreased by 42.71% and 55.63% respectively. The gradual decline in the DDC of PPIs and 5-HT3 antagonists may be associated with the implementation of national centralized drug procurement in China. The most common comorbidities for HG in this study included multiple pregnancies, thyroid disease and chronic disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>From 2019 to 2024, the number of patients with HG increased, while medication costs decreased. This trend is temporally consistent with the progressive implementation of China\u2019s centralized drug-procurement program, which may have contributed to alleviating the economic burden on patients. The average age of patients showed no significant change, while the proportion of advanced maternal age cases exhibited an increasing trend, which may be associated with postponed childbearing intentions. Vitamin B6, omeprazole, and metoclopramide were the most frequently used medications, which consistent with the medication structure recommended by national guidelines. Notably, the usage of ondansetron and metoclopramide has risen significantly, while the frequency of antihistamine use remains lower than that of international standards. Furthermore, multiple pregnancies thyroid dysfunction and chronic disease were the most common comorbidities for HG prescription.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1828618","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:17:35Z","timestamp":1779949055000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world pharmacological treatment of patients with hyperemesis gravidarum in 9 cities of China from 2019 to 2024: a cross-sectional analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaqian","family":"Pan","sequence":"first","affiliation":[{"name":"Pharmacy Department, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Obstetrics & Gynecology Hospital of Fudan University","place":["Shanghai, China"]},{"name":"Pharmacy Department, Obstetrics and Gynecology Hospital of Fudan University, Yangtze River Delta Integration Demonstration Zone (QingPu)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Obstetrics and Gynecology Hospital of Fudan University, Yangtze River Delta Integration Demonstration Zone (QingPu)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianli","family":"Wang","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Obstetrics & Gynecology Hospital of Fudan University","place":["Shanghai, China"]},{"name":"Pharmacy Department, Obstetrics and Gynecology Hospital of Fudan University, Yangtze River Delta Integration Demonstration Zone (QingPu)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Obstetrics & Gynecology Hospital of Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-026-05216-w","article-title":"Hyperemesis gravidarum revisited: from GDF15 biology to precision multimodal therapy","author":"Alshaikh","year":"2026","journal-title":"Naunyn-Schmiedeberg's Archives Pharmacology"},{"key":"B2","unstructured":"2022"},{"key":"B4","first-page":"57","article-title":"Clinical efficacy of diphenhydramine combined with vitamin B1 and vitamin B6 in treating hyperemesis gravidarum","volume":"4","author":"Deng","year":"2025","journal-title":"J. Women Children's Health Guide"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e215329","DOI":"10.1001\/jamanetworkopen.2021.5329","article-title":"Comparison of pregnancy outcomes of patients treated with ondansetron vs alternative antiemetic medications in a multinational, population-based cohort","volume":"4","author":"Dormuth","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"B6","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":"B7","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ejogrb.2015.03.028","article-title":"Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum","volume":"189","author":"Fejzo","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/01.AOG.0000195059.82029.74","article-title":"Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy","volume":"107","author":"Fell","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e13261","DOI":"10.1111\/ijcp.13261","article-title":"Assessment of discharge treatment prescribed to women admitted to hospital for hyperemesis gravidarum","volume":"73","author":"Fiaschi","year":"2019","journal-title":"Int. J. Clin. Pract."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1111\/1471-0528.17739","article-title":"The management of nausea and vomiting in pregnancy and hyperemesis gravidarum (Green-top guideline no. 69)","volume":"131","author":"Gadsby","year":"2024","journal-title":"BJOG Int. J. Obstetrics and Gynaecol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1038\/ajg.2009.122","article-title":"The safety of proton pump inhibitors (PPIs) in pregnancy: a meta-analysis","volume":"104","author":"Gill","year":"2009","journal-title":"Am. J. Gastroenterol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.1001\/jama.2018.18307","article-title":"Association of maternal first-trimester ondansetron use with cardiac malformations and oral clefts in offspring","volume":"320","author":"Huybrechts","year":"2018","journal-title":"JAMA"},{"key":"B13","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1001\/jama.2019.18587","article-title":"Intravenous ondansetron in pregnancy and risk of congenital malformations","volume":"323","author":"Huybrechts","year":"2020","journal-title":"JAMA"},{"key":"B14","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.ejogrb.2019.04.043","article-title":"Predictive factors of hyperemesis gravidarum: a systematic review","volume":"238","author":"Ioannidou","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"B15","first-page":"127","article-title":"Ondansetrone or metoclopromide? Which is more effective in severe nausea and vomiting of pregnancy? A randomized trial double-blind study","volume":"40","author":"Kashifard","year":"2013","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s00737-017-0770-5","article-title":"Hyperemesis gravidarum and the risk of emotional distress during and after pregnancy. Arch. Womens Ment","volume":"20","author":"Kjeldgaard","year":"2017","journal-title":"Health"},{"key":"B17","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1093\/ije\/dyz255","article-title":"Ondansetron use in the first trimester of pregnancy and the risk of neonatal ventricular septal defect","volume":"49","author":"Lemon","year":"2020","journal-title":"Int. J. Epidemiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1111\/apt.15610","article-title":"Systematic review with meta-analysis: the risks of proton pump inhibitors during pregnancy. Aliment","volume":"51","author":"Li","year":"2020","journal-title":"Pharmacol. Ther."},{"key":"B19","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.bpg.2007.06.002","article-title":"Gastrointestinal medications in pregnancy","volume":"21","author":"Mahadevan","year":"2007","journal-title":"Best. Pract. Res. Clin. Gastroenterol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"20503121241257163","DOI":"10.1177\/20503121241257163","article-title":"Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: multicenter cross-sectional study","volume":"12","author":"Mohammed","year":"2024","journal-title":"SAGE Open Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e16198","DOI":"10.1111\/jog.16198","article-title":"Prolonged prothrombin time in hyperemesis gravidarum as an indicator of vitamin K deficiency","volume":"51","author":"Nozomi","year":"2025","journal-title":"Journal Obstetrics Gynaecology Research"},{"key":"B22","doi-asserted-by":"publisher","first-page":"801","DOI":"10.3760\/cma.j.issn.0529-567x.2015.11.001","article-title":"Expert consensus on the diagnosis and clinical management of hyperemesis gravidarum (2015)","volume":"50","author":"Obstetrics Subgroup","year":"2015","journal-title":"Zhonghua. Fu. Chan. Ke. Za. Zhi."},{"key":"B3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.19577\/j.1007-4406.2023.03.014","article-title":"Drug selection and pharmaceutical care for patients with hyperemesis gravidarum combined with gastroesophageal reflux and abnormal liver enzymes","volume":"3","author":"Pan","year":"2023","journal-title":"Chin. J. Clin. Pharm."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.1111\/aogs.14966","article-title":"Risk factors and recurrence of hyperemesis gravidarum: a population-based record linkage cohort study. Acta","volume":"103","author":"Pont","year":"2024","journal-title":"Obstet. Gynecol. Scand."},{"key":"B24","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/00002820-198402000-00003","article-title":"Development of reliable and valid measures of nausea and vomiting","volume":"7","author":"Rhodes","year":"1984","journal-title":"Cancer Nurs."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e0257584","DOI":"10.1371\/journal.pone.0257584","article-title":"Use of metoclopramide in the first trimester and risk of major congenital malformations: a systematic review and meta-analysis","volume":"16","author":"Sun","year":"2021","journal-title":"PLoS One"},{"key":"B26","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.autneu.2016.07.005","article-title":"Analysis of pre- and post-pregnancy issues in women with hyperemesis gravidarum","volume":"202","author":"Tian","year":"2017","journal-title":"Auton. Neurosci-Basic Clin."},{"key":"B27","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.ekir.2017.01.005","article-title":"Proton pump inhibitors and kidney disease - GI upset for the nephrologist?","volume":"2","author":"Toth-Manikowski","year":"2017","journal-title":"Kidney Int. Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"306","DOI":"10.12280\/gjfckx.20231063","article-title":"Current status and future prospects of managing nausea and vomiting during pregnancy","volume":"51","author":"Wu","year":"2024","journal-title":"J. Int. Obstet. Gynecol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.19538\/j.fk2024120116","article-title":"Analysis of the management of nausea and vomiting of pregnancy and hyperemesis gravidarum based on global guideline","volume":"40","author":"Xu","year":"2024","journal-title":"Chin. J. Pract. Gynecol. Obstet."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1828618\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:17:40Z","timestamp":1779949060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1828618\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":29,"alternative-id":["10.3389\/fphar.2026.1828618"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1828618","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"1828618"}}