RESUMEN
Se hace una revisión de la etiología, fisiopatología y factores de riesgo de las náuseas y vómitos que ocurren durante el embarazo, así como del impacto, en casos severos o persistentes, en la salud de la madre, y del feto y del recién nacido. Se revisan los tratamientos propuestos, farmacológicos unos, no farmacológicos otros, resaltando el evidente beneficio terapéutico de la combinación de piridoxina con doxilamina y la evidencia de su inocuidad, que estuvo en entredicho a principio de la década de 1980...
Asunto(s)
Embarazo , Doxilamina/uso terapéutico , Embarazo/metabolismo , Náusea/diagnóstico , Piridoxina/uso terapéutico , Vómitos/diagnósticoRESUMEN
OBJECTIVE: To determine the effects of nausea and vomiting of pregnancy (NVP) and its treatment with diclectin on child neurodevelopment. STUDY DESIGN: An observational cohort study of mother-child pairs ascertained via a pregnancy call-in center was conducted. Three groups of children were studied: 45 with NVP and diclectin, 47 with NVP no diclectin, and 29 with no NVP. Phone calls to mothers during pregnancy and 6 to 9 months after childbirth yielded information on pregnancy, birth, and early child development. Children aged 3 to 7 years received a comprehensive set of psychological tests. Mothers were assessed for IQ and socioeconomic status. RESULTS: All children scored in the normal range for IQ, with the NVP-exposed group scoring higher than the non-exposed group on Performance IQ (P < .02), NEPSY Verbal Fluency (P < .003) and Phonological Processing (P < .004), and McCarthy Numerical Memory (P < .004). Predictors of enhanced results were NVP severity and maternal IQ. CONCLUSIONS: NVP has an enhancing effect on later child outcome. Diclectin does not appear to adversely affect fetal brain development and can be used to control NVP when clinically indicated.