Full Length
Research Paper
Effectiveness
of Vitamin B6 in the Treatment of Nausea and Vomiting in Early Pregnancy among Primi
Antenatal Mothers
Dineshwori
Chanu Paonam [1] and Dr. Jubin Varghese2
1 Ph D Scholar, Department of Nursing, Desh
Bhagat University, Punjab, India.
2 Associate Professor, Department of
Nursing, Desh Bhagat University, Punjab, India.
ARTICLE DETAILS
ABSTRACT
1. Introduction
A first pregnancy is similar to any other first experience. When a woman
becomes pregnant, she is acutely aware that a new life is developing inside her
for the following nine months. She is curious and concerned about the upcoming
changes. The first trimester of pregnancy is marked with enthusiasm and
celebration. However, it can also be a time of significant physical and
emotional transitions. Many women encounter modest complications during
pregnancy as a result of hormonal and metabolic changes. These illnesses should
be treated properly since they can worsen and become life-threatening.
Morning sickness is nausea with or without vomiting. It often develops
between 4 and 6 weeks of gestation and resolves by the end of the third month.
Severity ranges from moderate aversion for particular foods to severe vomiting.
The illness is not limited to the early morning hours; it can strike at any
time of day. Several
hormones were suggested to be the cause of NVP. Among these are human chorionic
gonadotropin (HCG), and elevated estrogen. Pyridoxine, or vitamin B6, is a water-soluble vitamin that your body
needs for many different processes.
It is necessary for the synthesis of red blood cells and
neurotransmitters, as well as for the metabolism of protein, fat, and
carbohydrates. Consuming vitamin B6 helps the body regulate its blood sugar
levels and reduces nausea and vomiting. The entire amount of vitamin B6
required by pregnant women should come from their food and prenatal
supplements. A normal dose of vitamin B6 for morning sickness is 10 mg to 25 mg
three times a day.
1.1 Objectives
To assess the level of nausea and vomiting before and
after intervention in early pregnancy among primi antenatal mothers in
experimental group and control group. To assess the effectiveness of vitamin B6
on nausea and vomiting in early pregnancy among primi antenatal mothers in
experimental group. To find out the association between level of nausea with
selected demographic variables in early pregnancy among primi antenatal mothers
1.2 Research hypothesis
H1-There will be significant difference between pre-test and
post-test scores on level of nausea and vomiting among primi antenatal mothers
in experimental group at 0.05 levels.
H2-There will be significant difference between pre-test and
post-test scores on level of nausea and vomiting among primi antenatal mothers
in control group at 0.05 levels.
H3-There will be significant difference between post test
scores on level of nausea and vomiting among primi antenatal mothers in control
and experimental group at 0.05 levels.
H4-There will be
significant association between levels of nausea and vomiting among primi
antenatal mothers with selected demographic variables at 0.05 levels.
2. Materials
and methods
2.1 Study area
A quasi-experimental
study was carried out to assess the effectiveness of vitamin B6 in the
treatment of nausea and vomiting in early pregnancy among primi antenatal
mothers, in Arihant Hospital OPD.
2.2 Sampling Population
and size
The participants were
primi antenatal mothers who were attending antenatal OPD in Arihant Hospital,
Dehradun However, mothers who are taking other home remedy, antiemetic drugs
and who are in risk were excluded from the study. Out of the eligible
participants, 40 mothers were included in the study (20 experimental and 20
control).
2.3 Sampling Methodology
Non-probability
purposive sampling technique was used for selecting the sample for the study.
2.4 Data Analysis
The study was conducted
using modified Rhodes Index of nausea and vomiting and retching. The scales
were classified as symptoms experienced, symptoms occurrence and symptoms
distress. Pretest was conducted for both the experimental and the control
group, then vitamin B6 25mg was administered for seven consecutive days morning
and evening on the same dates of pretest only to experimental group. Post-test
was conducted on 8th day using the same scale to evaluate the
effectiveness of Vitamin B6. The results were analysed using descriptive and
inferential statistic, on the basis of objectives and hypothesis of the study.
The results were presented in table form and also visually represented using
bar diagrams.
3.Results
Table 1. Frequency and Percentage Distribution of
Demographic Variables.
N
= 40
|
Characteristics |
Category |
Respondents |
|||||
|
Control(n=20) |
Experimental
(n=20) |
Combined(n=40) |
|||||
|
N |
% |
N |
% |
N |
% |
||
|
Age
group (years) |
18-20 |
10 |
50.0 |
13 |
65.0 |
23 |
57.5 |
|
21-23 |
7 |
35.0 |
4 |
20.0 |
11 |
27.5 |
|
|
24-26 |
3 |
15.0 |
3 |
15.0 |
6 |
15.0 |
|
|
Educational
status |
Illiterate |
4 |
20.0 |
6 |
30.0 |
10 |
25.0 |
|
Primary |
7 |
35.0 |
8 |
40.0 |
15 |
37.5 |
|
|
Secondary |
5 |
25.0 |
2 |
10.0 |
7 |
17.5 |
|
|
PUC |
4 |
20.0 |
4 |
20.0 |
8 |
20.0 |
|
|
Occupational
Status |
House
wife |
5 |
25.0 |
5 |
25.0 |
10 |
25.0 |
|
Daily
wages |
7 |
35.0 |
7 |
35.0 |
14 |
35.0 |
|
|
Self
Employed |
4 |
20.0 |
2 |
10.0 |
6 |
15.0 |
|
|
Private |
4 |
20.0 |
6 |
30.0 |
10 |
25.0 |
|
|
Duration
of Married life |
<1
year |
4 |
20.0 |
8 |
40.0 |
12 |
30.0 |
|
1-2
years |
14 |
70.0 |
9 |
45.0 |
23 |
57.5 |
|
|
3-4
years |
2 |
10.0 |
3 |
15.0 |
5 |
12.5 |
|
|
Duration
of pregnancy |
4-6
weeks |
7 |
35.0 |
6 |
30.0 |
13 |
32.5 |
|
7-9
weeks |
8 |
40.0 |
10 |
50.0 |
18 |
45.0 |
|
|
10-12
weeks |
5 |
25.0 |
4 |
20.0 |
9 |
22.5 |
|
Table: 2 Overall Pretest mean nausea and vomiting scores among control and experimental
group
|
Religion |
Hindu |
16 |
80.0 |
14 |
70.0 |
30 |
75.0 |
|
Muslim |
4 |
20.0 |
6 |
30.0 |
10 |
25.0 |
|
|
Food
habits |
Vegetarian |
9 |
45.0 |
8 |
40.0 |
17 |
42.5 |
|
Non
vegetarian |
11 |
55.0 |
12 |
60.0 |
23 |
57.5 |
|
|
Type
of family |
Nuclear |
5 |
25.0 |
6 |
30.0 |
11 |
27.5 |
|
Joint |
15 |
75.0 |
14 |
70.0 |
29 |
72.5 |
|
|
Family
Income/month |
Rs.2,000-4,000 |
9 |
45.0 |
8 |
40.0 |
17 |
42.5 |
|
Rs.4,001-6,000 |
6 |
30.0 |
6 |
30.0 |
12 |
30.0 |
|
|
Rs.6,001-9,000 |
5 |
25.0 |
6 |
30.0 |
11 |
27.5 |
|
|
Health
service utilization |
Government |
18 |
90.0 |
18 |
90.0 |
36 |
90.0 |
|
Private |
2 |
10.0 |
2 |
10.0 |
4 |
10.0 |
|
|
Previous
Information on Vitamin B6 |
No |
20 |
100.0 |
20 |
100.0 |
40 |
100.0 |
N = 40
|
Groups |
Max Score |
Sample (n) |
Respondents
Nausea and Vomiting Scores |
Paired ‘t’ Test |
||
|
Mean |
Mean (%) |
SD (%) |
|
|||
|
Control |
32 |
20 |
21.95 |
68.6 |
14.6 |
1.39 NS |
|
Experimental |
32 |
20 |
19.55 |
61.1 |
19.3 |
|
NS : Non- Significant,
t (0.05, 38 df) = 1.96
Table 2 reveals overall pretest mean nausea and vomiting scores of
experimental group and control group. The overall combined mean pretest score
of experimental and control group are 61.1% and 68.6% and ‘t’ value is 1.39
which was non-significant.
However, the statistical paired t test implies that there is no
significant difference in the pretest nausea and vomiting scores of experimental
and control groups which was statistically non-significant at 0.05 level.
Fig 1: Aspect wise posttest mean nausea and vomiting scores among control and
experimental group.
Fig 2: Aspect wise
pretest and post-test nausea and vomiting scores of experimental groups
Fig 3: Aspect wise
pretest and posttest nausea and vomiting scores of control group
Table
3: Over all Post test Mean Nausea and Vomiting Scores
among Control and Experimental group
N=40
|
Groups |
Sample (n) |
Respondents
Nausea and Vomiting Scores |
Paired ‘t’ Test |
||
|
Mean |
Mean (%) |
SD (%) |
|||
|
Control |
20 |
21.50 |
67.2 |
15.4 |
10.50* |
|
Experimental |
20 |
6.10 |
19.1 |
13.5 |
|
NS : Non-Significant, t (0.05, 38 df) = 1.9
Table
3: Reveals overall posttest mean nausea and vomiting
scores of experimental group and control group. The overall combined mean post
test score of experimental and control group are 6.10% and 21.50% and t’ value
was 10.50 which was significant at 0.05 level. Therefore, research
hypothesis H3 was
accepted which indicates that Vitamin B6 was
effective in treating of nausea and vomiting during pregnancy.
Table 4: Association
between pretest nausea and vomiting experience level with selected demographic
variables N-20
|
Demographic variables |
Symptom Experience |
Symptom Occurrence |
Symptom Distress |
|||
|
X2 |
P value |
X2 |
P value |
X2 |
P value |
|
|
Age |
36.8* |
<0.05 |
2.29 NS |
>0.05 |
23.3* |
<0.05 |
|
Duration
of pregnancy |
3.57 NS |
>0.05 |
6.00* |
<0.05 |
3.32 NS |
>0.05 |
|
Religion |
1.25 NS |
>0.05 |
1.67 NS |
>0.05 |
0.06 NS |
>0.05 |
|
Educational
status |
1.70 NS |
>0.05 |
3.05 NS |
>0.05 |
0.88 NS |
>0.05 |
|
Occupational
status |
1.38 NS |
>0.05 |
2.59 NS |
>0.05 |
1.05 NS |
>0.05 |
|
Food
habits |
0.05 NS |
>0.05 |
0.61 NS |
>0.05 |
0.09 NS |
>0.05 |
|
Duration
of married life |
2.14 NS |
>0.05 |
0.76 NS |
>0.05 |
3.67 NS |
>0.05 |
|
Type of
family |
6.67* |
<0.05 |
4.36* |
<0.05 |
7.94* |
<0.05 |
|
Family
income / month |
0.07 NS |
>0.05 |
0.62 NS |
>0.05 |
1.64 NS |
>0.05 |
* Significant at 5%
Level, NS: Non-significant
Table 4
indicates exist of significant association among the control group in some of
the demographic variables with the pretest scores and non-significant
association with some variables
Table
5: Association between Demographic variables and
Pretest Nausea and Vomiting level among Experimental group
N = 40
|
Demographic
variables |
Symptom
Experience |
Symptom
Occurrence |
Symptom
Distress |
|||
|
X2 |
P value |
X2 |
P value |
X2 |
P value |
|
|
Age
|
21.6* |
<0.05 |
21.6* |
<0.05 |
11.8* |
<0.05 |
|
Duration
of pregnancy |
10.77* |
<0.05 |
7.78* |
<0.05 |
7.78* |
<0.05 |
|
Religion
|
3.78 NS |
>0.05 |
6.71* |
<0.05 |
2.54 NS |
>0.05 |
|
Educational
status |
5.90 NS |
>0.05 |
8.72* |
<0.05 |
3.51 NS |
>0.05 |
|
Occupational
status |
3.53 NS |
>0.05 |
5.58 NS |
>0.05 |
2.30 NS |
>0.05 |
|
Food
habits |
7.18* |
<0.05 |
4.20* |
<0.05 |
1.25 NS |
>0.05 |
|
Duration
of married life |
9.50* |
<0.05 |
7.27* |
<0.05 |
2.93 NS |
>0.05 |
|
Type
of family |
0.01 NS |
>0.05 |
1.94 NS |
>0.05 |
0.16 NS |
>0.05 |
|
Family
income / month |
0.95 NS |
>0.05 |
1.25NS |
>0.05 |
2.64 NS |
>0.05 |
* Significant at 5% Level, NS: Non-significant
Table 5 indicates exist
of significant association among the experimental group in some of the
demographic variables with the pretest scores and non-significant association
with some demographic variables.
4. Discussion
Objective - I: To assess the level of nausea and vomiting in early
pregnancy among primi antenatal mothers in experimental and control group.
The overall pretest mean
nausea and vomiting scores of control group was 68.6% and whereas in
experimental group it is 61.1%. The pretest standard deviation of control group
was 14.6 whereas in experimental group it is 19.3. The paired ‘t’ test value
was 1.39 which was non-significant.
The above finding was supported by a study conducted by Masami Hirose et al. 2019 a prospective cohort study from August 2018 to
February 2019 on the impact of nausea, vomiting, and social support on
health-related quality of life during early pregnancy among early pregnant
women treated as perinatal outpatients in a general hospital. At their initial
prenatal appointment, 153 pregnant women aged 20 and above were less than 20 weeks
pregnant. Participants completed the Index of Nausea, Vomiting, and Retching
(INVR), the 12-item Short Form Health Survey (SF-12), and the Multidimensional
Scale of Perceived Social Support (MSPSS) in addition to reporting their
sociodemographic data. They also re-completed the INVR and SF-12 at follow-up
checkups up to three times. After correcting for internal correlations and
confounding factors, INVR was found to be significantly adversely linked with
the physical component summary scale score of the SF-12, whereas MSPSS had no
association with the physical component summary scale. In contrast, both INVR
and MSPSS scores were substantially linked with the SF-12 mental component
summary scale score, negatively and favourably, respectively. The degree of
nausea and vomiting has a substantial impact on physical quality of life in
early pregnancy. Both nausea and vomiting, as well as social support, have a
major and independent effect on mental quality of life. Health workers should
be aware of these effects and how social support can help improve mental
health.
Objective -II: To assess the effectiveness of vitamin B6 on nausea and
vomiting in early pregnancy among primi antenatal mothers of experimental
group.
The posttest mean nausea and vomiting scores
and paired ‘t’ value in regard to symptom experience was 42.8 and 21.51, in the
aspect of symptom occurrence 41.0 and 15.67 and in the aspect of symptom
distress the values are 41.7 and 16.2
However, the statistical paired ‘t’ test implies that there is
difference in the pretest and posttest nausea and vomiting scores of
experimental group in various aspects which was found statistically significant
at .05% level. Hence the first research hypothesis H1 is accepted at
0.05 levels which indicates vitamin B6 is effective on reducing of nausea and
vomiting in early pregnancy among first primi antenatal mothers.
The current study
findings reveal that, in the aspect of symptom experience mean posttest nausea
and vomiting score of Experimental Group and Control Group was 19.01%
and 66.3%, in the aspect of symptom occurrence score was 20% and 69% and in
symptom distress score was 17.5% and 66.7%. The obtained ‘t’ value in the
aspect of symptom experience were 9.87, in the aspect of symptom occurrence
9.89 and in the aspect of symptom distress 11.50 Hence, there is significant
difference in the post test nausea and vomiting scores of primi antenatal
mothers among Experimental and Control Group. Therefore, research hypothesis
H3 is accepted.
The above findings were
supported by a study conducted by Jayawardena R.
et al. 2023 studied the effects of pyridoxine (vitamin B6) supplementation on
nausea and vomiting during pregnancy. The current study seeks to carefully
examine the available evidence supporting pyridoxine's efficacy in the
treatment of NVP. Data were gathered through a step-by-step search of the
online medical databases listed below using keywords. Studies that reported
interventions using pyridoxine supplementation alone or in combination with
other active agents were included. A meta-analysis was conducted using the PUQE
score and Rhode's score for nausea and vomiting. Initial database searches
yielded 548 potentially eligible publications, from which 18 studies meeting
the inclusion criteria were selected. Eight research revealed that
supplementing with pyridoxine alone had a positive effect, while six others
found that supplementing with pyridoxine in combination with another active
substance was beneficial. Supplementing pyridoxine alone or with an active
ingredient significantly improved nausea symptoms, as measured by Rhode's score
[0.78 [95% CI: 0.26, 1.31; p = 0.003; I2 = 57%,
p = 0.10]] and PUQE score [0.75 [95% CI: 0.28, 1.22;
p = 0.002; I2 = 0%, p = 0.51],
respectively]. Pyridoxine supplementation, both alone and in combination with
an active substance, has been shown to benefit women suffering with NVP.
5. Conclusion
Nausea and vomiting
during early gestation continue to be an important public health concern,
affecting women, their families, and society on physiological, emotional,
social, and economic levels. The usage of ginger and vitamin B6 in early
gestation can help women who are experiencing nausea and vomiting by reducing
the severity of their symptoms and giving them an alternate therapy option for
managing such symptoms. This meta-analysis suggested that supplementing
with vitamin B6 considerably reduces nausea and vomiting in early
pregnancy. Additionally, vitamin B6 has a low risk
of side effects, and is available without a prescription. Vitamin B6 is
required for the body's overall health and fitness and also for the proper
functioning of the brain and nerve system, and so plays an important part in
the development of the developing fetus. To validate the efficacy
of Vitamin B6 supplements in the management of NVP, larger sample size would be
required.
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