Hyperemesis Gravidarum & Neuropsychiatric Disorders in Pregnancy
- Hyperemesis gravidarum (HG) is a severe form of morning sickness affecting up to 3.6% of all pregnancies.
- Researchers from king's College London and South London and Maudsley NHS Foundation Trust conducted a retrospective cohort study using the TriNetX Global Collaborative network.
- The study examined 24 neuropsychiatric and mental health outcomes reported within one year of HG diagnosis.
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Hyperemesis Gravidarum Linked to Increased Neuropsychiatric Risks
What is Hyperemesis Gravidarum (HG)?
Hyperemesis gravidarum (HG) is a severe form of morning sickness affecting up to 3.6% of all pregnancies. it’s characterized by prolonged and severe nausea and vomiting, leading to dehydration and weight loss. Unlike typical morning sickness, HG often extends beyond the first trimester, though the majority of cases do resolve by the second. Women with HG may experience significant anxiety about leaving home, feelings of isolation, and uncertainty about their ability to continue the pregnancy. The condition is the most common cause of hospitalisation during the first trimester.
Study Methodology and Findings
Researchers from king’s College London and South London and Maudsley NHS Foundation Trust conducted a retrospective cohort study using the TriNetX Global Collaborative network. This network provides anonymized electronic healthcare record data from 18 countries, encompassing a substantial sample size of 476,857 pregnant women diagnosed with HG.
The study examined 24 neuropsychiatric and mental health outcomes reported within one year of HG diagnosis. The results revealed a greater than 50% increased risk in 13 conditions. Specifically, the risks were doubled for Wernicke’s encephalopathy (a neurological condition caused by vitamin B1 deficiency), refeeding syndrome (complications from rapid re-introduction of food after malnutrition), eating disorders, and depression. Postpartum depression was 2.7 times more likely in women who experienced HG.
Increased Risk Breakdown
| Condition | Increased Risk |
|---|---|
| Postpartum Psychosis | >50% |
| Post-Traumatic Stress Disorder | >50% |
| Wernicke’s Encephalopathy | doubled |
| Refeeding Syndrome | Doubled |
| Eating disorders | Doubled |
| Depression (General) | Doubled |
| Postpartum Depression | 2.7x |
Risk Factors and Underlying Causes
Maternal risk factors for HG are diverse,ranging from biological predispositions to socioeconomic factors. Biological factors include pre-existing conditions like thyroid and parathyroid disease, Type 1 diabetes, and a history of previous pregnancies complex by HG. Socioeconomic deprivation and ethnicity also appear to play a role.
Recent research, including a study published in Nature, suggests that sensitivity to the hormone GDF-15 may be a key driver of HG. GDF-15 is produced by the placenta and is thought to influence appetite and nausea. Variations in GDF-15 sensitivity could explain why some women experience HG while others do not.