Marlena S Fejzo1, Aromalyn Magtira2, Frederic Paik Schoenberg2, Kimber Macgibbon3, Patrick M Mullin4. 1. University of California, Los Angeles, Department of Obstetrics, Gynecology, and Medicine, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA. Electronic address: mfejzo@mednet.ucla.edu. 2. University of California, Los Angeles, Department of Statistics, Los Angeles, CA, USA. 3. Hyperemesis Education and Research Foundation, Leesburg, VA, USA. 4. Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA.
Abstract
OBJECTIVE: The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. STUDY DESIGN: Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. RESULTS: Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (P<0.0005). Among characteristics of HG pregnancies, only early onset of symptoms (prior to 5 weeks gestation) was significantly linked to neurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. CONCLUSION: Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay.
OBJECTIVE: The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. STUDY DESIGN: Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. RESULTS:Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (P<0.0005). Among characteristics of HG pregnancies, only early onset of symptoms (prior to 5 weeks gestation) was significantly linked to neurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. CONCLUSION:Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay.
Authors: Shawnta Y Chaney; Shradha Mukherjee; Anand Giddabasappa; Elda M Rueda; W Ryan Hamilton; Jerry E Johnson; Donald A Fox Journal: Mol Vis Date: 2016-12-24 Impact factor: 2.367
Authors: Marlena S Fejzo; Olga V Sazonova; J Fah Sathirapongsasuti; Ingileif B Hallgrímsdóttir; Vladimir Vacic; Kimber W MacGibbon; Frederic P Schoenberg; Nicholas Mancuso; Dennis J Slamon; Patrick M Mullin Journal: Nat Commun Date: 2018-03-21 Impact factor: 14.919
Authors: Marlena Schoenberg Fejzo; Ronny Myhre; Lucía Colodro-Conde; Kimber W MacGibbon; Janet S Sinsheimer; M V Prasad Linga Reddy; Päivi Pajukanta; Dale R Nyholt; Margaret J Wright; Nicholas G Martin; Stephanie M Engel; Sarah E Medland; Per Magnus; Patrick M Mullin Journal: Mol Cell Endocrinol Date: 2016-09-20 Impact factor: 4.369