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In Utero Exposure to Extreme Morning Sickness May Harm Offspring

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UCLA Health
David Geffen School of Medicine
David Geffen School of Medicine

U Magazine

Women who experience extreme morning sickness during pregnancy are three times more likely to have children with developmental deficits — including attention disorders and language and speech delays — than women who have “normal” nausea and vomiting, a UCLA study found. The research was the first to look specifically at the relationship between in utero exposure to extreme morning sickness, also known as hyperemesis gravidarum (HG), and childhood neurologic developmental outcomes.

Marlena Fejzo, PhD, associate researcher at the David Geffen School of Medicine at UCLA, says the correlation was especially apparent in women whose HG symptoms began prior to five-weeks gestation. “These findings show that it is vital to take HG seriously so these pregnant women can get nutritional support right away,” Dr. Fejzo says. “An encouraging result is that we did not find any association with medications to treat this disorder and neurodevelopmental delays, so I speculate that the neurodevelopmental outcomes are more likely caused by nutrient deficiency early in pregnancy rather than medication.”

Illustration: Maja Moden

The cause of HG is unknown, and the symptoms are intense — including continuous nausea and vomiting so violent that it can cause detached retinas, blown eardrums, cracked ribs and torn esophagi. The symptoms can last for a month or two or for the entire pregnancy.
Children born to women with HG in the study had attention and sensory disorders and learning, speech and language delays and were 3.28 times more likely than the others to have neurodevelopmental delays. “There is an urgent need to address whether or not aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea and vomiting decreases that risk of neurodevelopmental delay,” Dr. Fejzo says.

Previous studies have shown that HG is associated with low-birth-weight babies, small size for gestational age and preterm births. Dr. Fejzo showed previously that children born to mothers who had extreme morning sickness were 3.6 times more likely to have behavioral or emotional disorders as adults.

Dr. Fejzo and her team are investigating the genetic basis of HG, and they hope to determine whether earlier treatment in women with symptoms limits or prevents the adverse outcomes identified in the study. “A significant increase in neurodevelopmental and behavioral disorders in children exposed to HG in utero was demonstrated, which suggests HG may be linked to lifelong effects on the exposed fetus,” the study states. “The cause for this is unknown but may be due to maternal stress, abnormal hormone levels during fetal development and/or maternal-newborn bonding after birth or malnutrition and vitamin deficiency.”

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