Chuck Bednar for redOrbit.com – @BednarChuck
Pregnant women who deal with extreme bouts of morning sickness are three times more likely to give birth to babies that have attention-related, speech or other neurological conditions, scientists from UCLA’s David Geffen School of Medicine report in a new study.
Writing in the online early edition of the European Journal of Obstetrics and Gynecology and Reproductive Biology, first author Marlena Fejzo, a research faculty member in the Department of Obstetrics and Gynecology, and her colleagues found a link between in utero exposure to an extreme form of morning and neurologic developmental outcomes throughout childhood.
The study, which is the first to specifically look at the condition called Hyperemesis Gravidarum and neurologic outcomes in youngsters, established that the link was the strongest in women who started experiencing symptoms prior to five weeks gestation, UCLA said in a statement.
Investigating the effects of HG on unborn children
The cause of HG is unknown, but the researchers describe its symptoms as “intense.” Among those symptoms, the authors explained, are continuous nausea and vomiting so violent that they can cause an expectant mother’s retinas to become detached, her eardrums to become blown, her ribs to crack and her esophagus to tear. Those symptoms often last for several months.
In their study, Fejzo and her colleagues looked at 312 children from 203 mothers who reported experiencing HG between 2007 and 2011, and compared them to 169 kids who were born to 89 mothers that did not suffer from the condition. They found that the HG children were more likely to suffer from attention and sensory disorders, as well as learning, speech and linguistic delays.
The women in the study experienced nausea and vomiting so severe that they had lost at least five pounds, and became dehydrated to the point where they needed to be administered fluids via IV, the researchers said. Children exposed in utero to severe morning sickness had a 3.28-fold increased risk of neurodevelopmental delays, Fejzo said, but the mechanism for exposure to HG and the resulting neurological development problems have not yet been identified.
Fejzo noted that the findings illustrate that it is important for expectant mothers and their doctors to take the condition seriously so that they can get the proper nutritional support. On the positive side, no link between the medications typically used to treat HG and neurodevelopmental delays was discovered, meaning that the likely cause is nutrient deficiency during early pregnancy.
Should pregnant women with morning sickness be worried?
One thing that Fejzo emphasized is that there is a big difference between regular morning sickness and HG, and that most mothers shouldn’t be concerned. The women featured in the study were losing weight and required IV fluids for dehydration, she told redOrbit via email, while women with normal morning sickness that do not require treatment such as medication or intravenous fluids do not have an increased risk to their unborn children.
“Women with HG have a high recurrence risk (around 80 percent), so women who have had HG should have a plan in place in their next pregnancy to be sure to get adequate fluids and vitamins, especially if symptoms start very early,” she explained. “Babies born to moms with HG should be tested early for neurodevelopmental delay because early intervention may help.”
“The biggest risk factor for HG besides having a previous pregnancy with HG, is having a sibling with HG,” which increases the risk by 17 times, the professor told redOrbit. “Therefore it is likely that there are genes that predispose to HG. We have collected saliva samples and are analyzing the genes of women and families with HG and comparing them to genes from women with normal nausea/vomiting in pregnancy.”
“We have performed exome sequencing on 10 families with HG,” Fejzo concluded. “So far we have found some evidence that mutations in genes involved in kidney and liver health may be linked to HG, but we have more work to do to show that HG may be caused by problems in filtering out the high levels of toxic hormone byproducts in early pregnancy.”
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