WebMD Medical News
Laura J. Martin, MD
Sept. 8, 2010 -- Treatments for morning sickness, the nausea and vomiting experienced by up to 80% of pregnant women, are plentiful, from using acupuncture or eating ginger to taking vitamin B6.
But the evidence that any of these treatments work is limited, according to a new review.
''There's no strong evidence about any treatment for morning sickness," researcher Anne Matthews, RN, PHD, a registered midwife at Dublin City University in Dublin, Ireland, tells WebMD.
She and her colleagues looked at the results of 27 trials involving 4,041 women taking a range of treatments.
The bright spot about morning sickness? "It usually improves over time," Matthews says. The review is published in the Cochrane Database of Systematic Reviews. The Cochrane Reviews bring together research on health care and are viewed as the ''gold standard'' for determining how effective different treatments are.
But Matthews and other doctors who reviewed the study say it can't hurt to try treatments that are safe, and that they may help some women.
Matthews and her colleagues searched the register for the Cochrane Pregnancy and Childbirth Group's Trials, looking for studies that assigned women with morning sickness to a treatment group or a control group.
In the 27 trials that met their criteria, many treatments were studied, including:
No studies of dietary or other lifestyle treatments were found that met the reviewers' criteria.
Morning sickness is a misnomer, Matthews tells WebMD, as it can occur any time of the day or night. It typically occurs mainly in the first trimester, from the 6th to the 12th week of pregnancy, but can last much longer.
Among the reviewers' findings:
If a woman with morning sickness asks what to do for relief, Matthews says she would tell her: "There isn't enough strong evidence to recommend any intervention."
However, she tells WebMD: "Women can decide with their practitioner if something is safe." Even if the treatment wasn't proven effective in the review, she says, women may still decide, in consultation with their doctor, to take it, if it's safe.
If so, she says, they should realize that the treatments don't have a strong scientific foundation to prove they work.
Even though many of the treatments reviewed aren't backed up by strong scientific evidence, some are worth a try, says Richard Frieder, MD, an ob-gyn at Santa Monica--UCLA Medical Center and Orthopaedic Hospital in Santa Monica, Calif., and assistant clinical professor at the University of California Los Angeles David Geffen School of Medicine.
He reviewed the report for WebMD but was not involved in it. "I commonly recommend to patients they have ginger supplements and eat a little something every two hours and drink at least three liters a day of salty or sugared liquid," he says.
Staying nourished and hydrated helps, he finds.
"Real life doesn't always mimic scientific findings, especially if you find a treatment that works for you, and some anecdotal evidence says it could work," says Joslyn Gumbs, MD, an associate professor of ob-gyn at the University of Southern California Keck School of Medicine, Los Angeles, who also reviewed the findings.
For many of the remedies, including vitamin B6 and ginger, "it doesn't hurt to try," she says, if your doctor agrees.
Both Gumbs and Frieder say they've had good luck quelling morning sickness in some women using drugs.
Available treatments for severe morning sickness, when a woman must be hospitalized and given medications and intravenous support, do work, Frieder says.
Time helps, too. ''By the 12th week, it's pretty much over," Gumbs says, but adds that some women do battle morning sickness during the entire pregnancy.
SOURCES:Anne Matthews, PhD, RN, registered midwife, School of Nursing, Dublin City University, Dublin, Ireland.Matthews A. Cochrane Database of Systematic Reviews, 2010, Issue 9.Richard Frieder, MD, ob-gyn, Santa Monica--UCLA Medical Center and Orthopaedic Hospital, Santa Monica, Calif.; assistant clinical professor, University of California Los Angeles David Geffen School of Medicine.Joslyn Gumbs, MD, associate professor of ob-gyn, University of Southern California Keck School of Medicine, Los Angeles.
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