Long-term mental health disorders and suicidal behaviors linked to excessive vomiting during pregnancy: Evidence from the UK biobank

Xiaona Na; Xijie Wang; Din Son Tan; Yufeng Tan; Celi Yang; Junhan Zhang; Yucheng Yang; John S Ji; Ai Zhao

doi:10.1016/j.jad.2025.119706

Long-term mental health disorders and suicidal behaviors linked to excessive vomiting during pregnancy: Evidence from the UK biobank

J Affect Disord. 2025 Jun 18:388:119706. doi: 10.1016/j.jad.2025.119706. Online ahead of print.

Authors

Xiaona Na¹, Xijie Wang¹, Din Son Tan¹, Yufeng Tan¹, Celi Yang¹, Junhan Zhang¹, Yucheng Yang¹, John S Ji¹, Ai Zhao²

Affiliations

¹ Vanke School of Public Health, Tsinghua University, Beijing 100084, China; Institute for Healthy China, Tsinghua University, Beijing 100084, China.
² Vanke School of Public Health, Tsinghua University, Beijing 100084, China; Institute for Healthy China, Tsinghua University, Beijing 100084, China. Electronic address: aizhao18@tsinghua.edu.cn.

PMID: 40541825
DOI: 10.1016/j.jad.2025.119706

Abstract

Background: The long-term effect of excessive vomiting during pregnancy (EVP) on women's mental health remains unclear. We aimed to investigate the association of EVP with the risks of mental disorders and suicide-related behaviors, and the potential influence of adverse pregnancy outcomes (APOs).

Method: 267,925 female participants without a prior history of mental disorders at baseline were recruited from the UK Biobank Study. Multivariable Cox proportional hazards models were used to estimate the associations between EVP and the risk of mental disorders and suicide-related behaviors. Mediation and network analyses were conducted to assess the role of other APOs.

Results: A total of 267,925 participants with a mean baseline age of 57.0 years were included in the primary analysis. Of these, 409 (0.15 %) reported experiencing EVP. During a median (Q1, Q3) follow-up time of 13.6 years, 33,526 (12.5 %) participants developed mental disorders, and 976 (0.4 %) experienced suicide-related behavior. EVP was associated with a higher risk of any mental disorders (adjusted Hazard Ratio [AHR]: 1.889, 95 % CI: 1.480, 2.412), Schizophrenia (AHR: 4.659, 95 % CI: 1.717, 12.645), mood disorders (AHR: 1.748, 95 % CI: 1.275, 2.397), and stress-related disorders (AHR: 2.088, 95 % CI: 1.481, 2.943). Pregnancy loss, gestational diabetes, hemoglobin levels, and the neutrophil-to-lymphocyte ratio mediate these associations. Mood disorders was a core node linking mental disorders to suicide-related behaviors.

Conclusions: EVP is associated with an increased risk of various mental disorders. Long-term mental health surveillance in women experiencing EVP is important, while further exploration on the underlying mechanism is required.

Keywords: Excessive vomiting during pregnancy; Lifespan health; Mental health; Network analysis; Population-based cohort study.