Toward a Deeper Understanding of Nausea, Vomiting, and Pregnancy Loss

Scientists and the medical community have advanced our understanding of the natural history of nausea and vomiting in pregnancy (NVP), which affects 50% to 80% of pregnant women.¹ In the early 20th century, physicians recognized the association between NVP and carbohydrate metabolism,² but some also ascribed a psychosomatic component to its etiology.³ Since then, researchers have proposed explanations for NVP that are grounded in evolutionary biology⁴ or pathophysiology.⁵ Studies have also found that the incidence of pregnancy loss is lower among pregnant women who experience NVP compared with those who do not.⁶ The study by Hinkle et al⁷ in this issue of JAMA Internal Medicine corroborates these findings and represents a clinical research approach that couples prospective data collection with the ability to detect early pregnancy.