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 Compared to children of women without hyperemesis gravidarum,
children who were exposed to the condition while in the womb were
more than three times as likely to be diagnosed with attention and
sensory disorders and learning and language delays by age eight,
researchers report.
Early onset of the nausea and vomiting - within the first five weeks
of gestation - was significantly tied to the likelihood of a child
having a developmental delay.
While the researchers can’t say exactly why the mothers' extreme
nausea in pregnancy would affect the children years after birth, the
lead author said it may be related to the influence of nutrition on
very early development of the embryo and fetus.
“What we did find is that very early symptoms do seem to increase
risk,” said Marlena Fejzo of the University of California, Los
Angeles, and the University of Southern California. “The theory
would then be women who get symptoms very early are getting
nutritional deficiency and dehydration and that’s leading to the
problems.”
Hyperemesis gravidarum is rare, Fejzo and her coauthors said online
April 2 in the European Journal of Obstetrics and Gynecology and
Reproductive Biology. Past studies have estimated rates at anywhere
from 0.3% of pregnancies in Sweden to almost 11% in China. More than
285,000 women a year in the U.S. are discharged from hospitals after
being treated for the condition, they note.
The researchers compared medical records and survey responses
regarding 312 children born to 203 mothers with hyperemesis
gravidarum and 169 children of 89 mothers without the condition. The
children were about 8 years old on average.
About 49% of children exposed to the condition had some kind of
neurodevelopment delay, compared to about 22% of children not
exposed to hyperemesis gravidarum, the researchers found.
Rates varied by type of delay, however.
For example, about 19% of children exposed to hyperemesis gravidarum
had attention deficit disorder or attention deficit hyperactivity
disorder, compared to about 6% of unexposed children.
And, about 24% of exposed children had a speech or language
impairment or delay, compared to about 2% of unexposed kids.
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While there is an increased risk, Fejzo said it’s important to note
that most children did not go on to have problems.
“The majority of women should not be concerned about this,” she told
Reuters Health. “It’s important to be aware, but I don’t think it’s
cause for alarm at this point.”
Also, she said, it’s important to note that none of the treatments
used to treat the condition were connected to the outcomes.
Fezjo and her coauthors did not have information about other factors
that are known to influence fetal development, such as the mother's
smoking, drinking or drug use.
Some pregnant women with hyperemesis gravidarum require intravenous
fluids, said Dr. Loralei Thornburg, who was not involved with the
new study. Some women may also need a feeding tube and medications.
The new study doesn’t say whether early treatment may reduce the
risk of these neurologic delays, said Thornburg, a high-risk
pregnancy expert at the University of Rochester Medical Center in
New York.
“Certainly this warrants investigation and warrants learning whether
early treatment actually decreases this risk,” she said.
SOURCE: http://bit.ly/1IIRHgO
Eur J Obstet Gynecol Reprod Biol 2015.
[© 2015 Thomson Reuters. All rights
reserved.] Copyright 2015 Reuters. All rights reserved. This material may not be published,
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