Reproduction Abstracts

Hyperemesis gravidarum (HG) is a leading cause of morbidity during pregnancy and has potential to affect maternal health and fetal development. Our first objective was to determine the association between HG and severe maternal morbidity.¹ Our second objective was to examine the association between HG and child morbidity.² We conducted a retrospective cohort study of hospital deliveries between 1989 and 2021, and a longitudinal cohort study of children born between 2006 and 2021. We used hospital discharge data from Quebec, Canada. The main exposure was maternal hyperemesis gravidarum requiring hospitalization or noted on the prenatal chart. The first outcome was severe maternal morbidity during pregnancy or up to 42 days postpartum. The second outcome was pediatric admission up to 16 years of age. We used adjusted regression models to calculate risk ratios, hazard ratios and 95% confidence intervals (CI) for the association between maternal HG and maternal and child morbidity. This study included 2.5 million pregnancies, 17 thousand of which were hospitalized for HG. Patients with HG were 1.5 times more at risk of developing any severe maternal morbidity (95% CI 1.4-1.6) compared with no HG. In adjusted models, patients with HG were 6.4 times more at risk of developing hepatic complications such as hepatic failure or fatty liver disease. Patients with HG were approximately 2.3 times more at risk of developing embolism/shock (95% CI 1.8-2.9), acute renal failure (95% CI 1.7-3.5) and cerebrovascular accidents (95% CI 1.1-4.5) compared to patients with no HG. Among 1.2 million children included in our longitudinal cohort, 7 thousand were born from mothers with HG. Children exposed to maternal HG had higher hospitalization rates at 16 years of age compared to unexposed children (47.6 vs 43.9 per 100 children). Children born from mothers with HG were 1.5 times more at risk of being hospitalized for developmental (95% CI 1.3-1.8), neurologic (95% CI 1.3-1.7), digestive (95% CI 1.3-1.5), or atopic disorders (95% CI 1.2-1.6) compared to unexposed children.In conclusion, these studies found that hyperemesis gravidarum is associated with severe maternal morbidities, including hepatic, cerebrovascular, renal complications at delivery or up to 42 days postpartum. We also found an association between maternal hyperemesis and risk of childhood hospitalization, especially for developmental, neurologic, digestive, and atopic disorders.

Keywords: Hyperemesis gravidarum, pregnancy complications, perinatal outcomes, fetal development, nutritional deficiency, pediatrics

References

3. Zerbo A, Kang-Auger S, Jutras G, et al. Hyperemesis gravidarum and risk of severe maternal morbidity: a retrospective cohort study. American Journal of Obstetrics & Gynecology. MFM 2024;6:101392.

4. Auger N, Padda B, Bégin P, et al. Hyperemesis gravidarum and the risk of offspring morbidity: a longitudinal cohort study. European Journal of Pediatrics. 2024;183(9):3843-3851.