Association of the 24-hour Pregnancy Unique Quantification of Emesis Index with Self-Rated Wellbeing Score: A Cross-Sectional Study

Abstract

Introduction: Nausea and Vomiting of Pregnancy (NVP) are common symptoms of pregnancy. Often, treatment is guided by subjective symptoms, leading to hospitalisation of these patients and unnecessary health costs. The 24-hour Pregnancy-Unique Quantification of Emesis (PUQE) index helps objectively quantify these symptoms and guide the management of these patients. Aim: To assess the association of the 24-hour PUQE index with the self-rated well-being score in evaluating the severity of NVP. Materials and Methods: In this cross-sectional study, a total of 207 women at 5 to 12 weeks of singleton pregnancy were recruited after obtaining informed consent. They were interviewed regarding their symptoms of nausea and vomiting based on a 24-hour PUQE index questionnaire, and a score was assigned to them. They were stratified as mild, moderate, or severe based on the score. The association of these symptoms with a selfrated well-being score and subjective symptoms such as the ability to take multivitamins, sleep pattern, liquid intake, and the need for hospitalisation was assessed. They were followed-up after four weeks, and a repeat score was obtained. Chi-square test was performed to compare the severity of PUQE-24. Results: The mean well-being score at the first visit was 3.381±1.650, and at the follow-up visit, it was 7±1.763. At the first visit, 46 out of 207 had a mild 24-hour PUQE score, 140 out of 207 had a moderate score, and 21 out of 207 had a severe score. During the follow-up visit, 123 out of 207 had a mild score, 77 out of 207 had a moderate score, and seven out of 207 had a severe score. There was a significant association between the mean self-rated well-being score and the 24-hour PUQE score at the first and follow-up visits (p-value=0.0001). Among the patients hospitalised at the first visit (21 out of 28), 75% belonged to the severe PUQE category. The mean liquid intake at the first visit was 24.363±10.357 mL/kg/hr, and at the followup visit was 29.972±10.691, showing a significant association with the severity of the 24-hour PUQE score (p-value=0.0001). A significant association was observed between the 24-hour PUQE scores of the first and follow-up visits (p-value=0.002). Conclusion: In this study, there was a significant association between the 24-hour PUQE score and the well-being score at both visits. Stratifying the severity of NVP objectively will guide us to choose the appropriate treatment and reduce the need for hospitalisation.