Perinatal outcomes of infants born to mothers with hyperemesis gravidarum: A systematic review and meta-analysis

Jansen, Larissa A.W.; Nijsten, Kelly; Limpens, Jacqueline; Eekelen, Rik van; Koot, Marjette H.; Grooten, Iris J.; Roseboom, Tessa J.; Painter, Rebecca C.

doi:10.1016/j.ejogrb.2023.03.004

Cited by 12 publications

(11 citation statements)

References 85 publications

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“…Therefore, it is difficult to draw comparisons to previous research. Nevertheless, our findings that more severe NVP was associated with an increased risk of preterm birth were in agreement with several studies of severe NVP (Temming et al, 2014) and hyperemesis gravidarum (Bolin et al, 2013; Dodds et al, 2006; Fiaschi et al, 2018; Jansen et al, 2023; Roseboom et al, 2011; Veenendaal et al, 2011), as was our finding that NVP in early pregnancy was not associated with an increased risk of preterm birth (Naumann et al, 2012; Weigel et al, 2006). However our findings disagree with cohort studies from Hungary (Czeizel & Puho, 2004) and Japan (Mitsuda et al, 2018) that found severe NVP was associated with a decrease in risk of preterm birth.…”

Section: Discussionsupporting

confidence: 93%

The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study

Schrager,

Parker,

Werler

2024

Birth Defects Research

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BackgroundNausea and vomiting of pregnancy (NVP) occurs in approximately 70% of pregnant people, with varying severity and duration. Treatments include pharmacologic and herbal/natural medications. The associations between NVP and birth outcomes, including preterm birth, small for gestational age (SGA), and low birth weight are inconclusive.ObjectiveTo determine whether NVP and reported medications are associated with adverse birth outcomes.MethodsWe used data from the population‐based, multisite National Birth Defects Prevention Study (1997–2011) to evaluate whether self‐reported NVP according to timing, duration, and severity or its specific treatments were associated with preterm birth, SGA, and low birth weight among controls without birth defects. Odds ratios (aOR) and 95% confidence intervals (CI) were adjusted for sociodemographic, reproductive, and medical factors. For any NVP, duration, treatment use, and severity score analyses, the comparison group was participants with no reported NVP. For timing analyses, the comparison group was women with no reported NVP in the same trimester of pregnancy.ResultsAmong 6018 participants, 4339 (72.1%) reported any NVP. Among those with NVP, moderate or severe symptoms were more common than mild symptoms. Any versus no NVP was not associated with any of the outcomes of interest. NVP in months 4–6 (aOR 1.21, 95% CI: 1.00, 1.47) and 7–9 (aOR 1.57, 95% CI: 1.22, 2.01) of pregnancy were associated with an increase in the risk of preterm birth. NVP lasting one trimester in duration was associated with decrease in risk of SGA (aOR: 0.74, 95% CI: 0.58, 0.95), and NVP present in every trimester of pregnancy had a 50% increase in risk of preterm birth (aOR: 1.50, 95% CI: 1.11, 2.05). For NVP in months 7–9 and preterm birth, ORs were elevated for moderate (aOR: 1.82, 95% CI: 1.26, 2.63), and severe (aOR: 1.53, 95% CI: 1.06, 2.19) symptoms. NVP was not significantly associated with low birth weight. Our analyses of medications were limited by small numbers, but none suggested increased risk of adverse outcomes associated with use of the medication.ConclusionMild NVP and NVP limited to early pregnancy appear to have no effect or a small protective effect on birth outcomes. Long‐lasting NVP, severe NVP, and NVP later in pregnancy may increase risk of preterm birth and SGA.

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Section: Discussionsupporting

confidence: 93%

The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study

Schrager,

Parker,

Werler

2024

Birth Defects Research

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“…Recently there has been further research finding previous work showing that GDF15 is implicated in hyperemesis gravidarum (47). HG is associated with low birth weight, potentially because of a mother’s inability to retain nutrients during pregnancy (48). Our findings are complementary because genetically higher maternal pre-pregnancy levels of GDF15 are likely to make a mother less sensitive to GDF15 produced by the fetus in the first trimester of pregnancy, which leads to lower levels of nausea and vomiting (47).…”

Section: Discussionmentioning

confidence: 99%

Effects of the maternal and fetal proteome on birth weight: a Mendelian randomization analysis

McBride,

Fernández-Sanlés,

Arab

et al. 2023

Preprint

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Fetal growth is an indicator of fetal survival, regulated by maternal and fetal influences, but little is known about the underlying molecular mechanisms. We used Mendelian randomization to explore the effects of maternal and fetal genetically-instrumented plasma proteins on birth weight using genome-wide association summary data (n=406,063 with maternal and/or fetal genotype), with independent replication (n=74,932 mothers and n=62,108 offspring), and colocalisation. Higher genetically-predicted maternal levels of PCSK1 increased birthweight (mean-difference: 9g (95% CI: 5g, 13g) per 1 standard deviation protein level). Higher maternal levels of LGALS4 decreased birthweight (-54g (-29g, -80g)), as did VCAM1, RAD51D and GP1BA. In the offspring, higher genetically-predicted fetal levels of LGALS4 (46g (23g, 70g)) increased birthweight, alongside FCGR2B. Higher offspring levels of PCSK1 decreased birth weight (-9g (-16g, 4g), alongside LEPR. Results support maternal and fetal protein effects on birth weight, implicating roles for glucose metabolism, energy homeostasis, endothelial function and adipocyte differentiation.

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“…Placental abruption 30 Birth weight < 1500 g 30 Offer ultrasonography to measure fetal growth in pregnancy if symptoms persist beyond second trimester Preterm delivery 30 Resuscitation or admission to NICU 30…”

Section: Perinatal Outcomesmentioning

confidence: 99%

“…Reduced insulin sensitivity 30 Anxiety disorders 31 Sleep problems 31 Attention-deficit/hyperactivity disorder 31 Autism spectrum disorder 31 Testicular cancer 31 Note: IV = intravenous, NICU = neonatal intensive care unit, PTSD = posttraumatic stress disorder. What is the optimal approach to management?…”

Section: Long-term Outcomes To Offspringmentioning

confidence: 99%

Diagnosis and treatment of hyperemesis gravidarum

Jansen,

Shaw,

Grooten

et al. 2024

CMAJ

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Perinatal outcomes of infants born to mothers with hyperemesis gravidarum: A systematic review and meta-analysis

Cited by 12 publications

References 85 publications

The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study

The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study

Effects of the maternal and fetal proteome on birth weight: a Mendelian randomization analysis

Diagnosis and treatment of hyperemesis gravidarum

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