Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and Nausea) Identifies Patients with Hyperemesis Gravidarum and Poor Nutritional Intake: A Prospective Cohort Validation Study

ObjectiveThe English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake.DesignA prospective cohort validation study.SettingHospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway.Sample38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers.MethodsData were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to15) and registered prospectively 24-hours nutritional intake by a food list form.Main outcome measuresDifferences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls.ResultsHyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, ppppConclusionPUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

### 研究目的
英文版本的妊娠特异性呕吐与恶心量化问卷（Pregnancy-Unique Quantification of Emesis and nausea, PUQE）可用于识别罹患重度妊娠剧吐（Hyperemesis Gravidarum, HG）的孕妇。本研究旨在探讨翻译后的挪威语版本PUQE——SUKK（SvangerskapsUtløst Kvalme Kvantifisering）的评分，是否与妊娠剧吐的严重程度及营养摄入情况相关。

### 研究设计
前瞻性队列验证研究。

### 研究场景
招募来自挪威西部的妊娠剧吐患者队列，以及来自挪威卑尔根的健康妊娠女性作为对照。

### 研究对象
38名因HG住院的妊娠剧吐患者，以及31名在卫生服务中心接受常规产前检查的健康妊娠对照女性。

### 研究方法
数据收集时间为2013年5月至2014年1月。所有研究对象填写挪威语版PUQE问卷（得分范围为3~15分），并通过食物清单表单前瞻性记录24小时内的营养摄入情况。

### 主要结局指标
妊娠剧吐患者与对照女性之间的PUQE评分、生活质量（Quality of Life, QOL）评分以及营养摄入情况的差异。

### 研究结果
与对照组相比，妊娠剧吐患者的孕周更短（中位孕周9.7周，95%置信区间8.6~10.6 vs 对照组11.9周，95%置信区间10.1~12.9，p=0.004），且孕前体重变化幅度更大：患者中位体重下降3kg（95%置信区间3~4kg），对照组则为中位体重增加2kg（95%置信区间0.5~2kg，pppp）。

### 研究结论
在挪威人群中，PUQE评分可作为重度妊娠剧吐及营养摄入不足的可靠评估指标。