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Medline ® Abstract for Reference 156

of 'Treatment and outcome of nausea and vomiting of pregnancy'

156
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Severe hyperemesis gravidarum is associated with reduced insulin sensitivity in the offspring in childhood.
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Ayyavoo A, Derraik JG, Hofman PL, Biggs J, Bloomfield FH, Cormack BE, Stone P, Cutfield WS
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J Clin Endocrinol Metab. 2013 Aug;98(8):3263-8. Epub 2013 Jun 7.
 
BACKGROUND: Hyperemesis gravidarum alters maternal (and possibly fetal) nutrition throughout pregnancy, but there are no data on long-term effects on offspring metabolism. Thus, we aimed to assess whether severe hyperemesis gravidarum (SHG) affects glucose homeostasis and body composition in the offspring in childhood.
METHODS: Healthy prepubertal children (aged 4-11 years) born at term were studied: offspring of mothers who were admitted to hospital with SHG (n = 36) and offspring of mothers from control pregnancies (n = 42). Primary outcome was insulin sensitivity measured using iv glucose tolerance tests and Bergman's minimal model. Other assessments included lipid and hormonal profiles and body composition using whole-body dual-energy x-ray absorptiometry.
RESULTS: Insulin sensitivity in SHG children was 20% lower than in controls (8.49 vs 10.60×10(-4)·min(-1)·(mU/L); P = .014). SHG children also had higher fasting insulin (6.88 vs 5.04 mIU/L; P = .024) and lower IGF binding protein 1 (11.8 vs 19.0 ng/mL; P = .004) concentrations than controls. Baseline cortisol concentrations were 22% higher in SHG offspring (256 vs 210 nmol/L; P = .021). Children in both groups were anthropometrically similar.
CONCLUSION: Children born to mothers who experienced SHG have lower insulin sensitivity, which may increase their long-term risk of developing diabetes mellitus. Follow-up of SHG offspring is essential to determine later risk of metabolic disease.
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Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
PMID