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Medline ® Abstracts for References 159,160

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

Weight loss in pregnancy and cardiometabolic profile in childhood: findings from a longitudinal birth cohort.
Grooten IJ, Painter RC, Pontesilli M, van der Post J, Mol B, van Eijsden M, Vrijkotte T, Roseboom TJ
BJOG. 2015 Nov;122(12):1664-73. Epub 2014 Aug 22.
OBJECTIVE: To investigate the consequences of weight loss in pregnancy on pregnancy outcomes and cardiometabolic profile in childhood.
DESIGN: Prospective birth cohort (ABCD study).
SETTING: Between 2003 and 2004, all pregnant women in Amsterdam were approached for study participation.
POPULATION: 7818 pregnant women were included, of which 3165 consented to having their children examined at 5-6 years of age. In 1956 children fasting capillary blood samples were also taken.
METHODS: At antenatal booking, women answered questions about their pregnancy and whether they suffered from severe weight loss (SWL;>5 kg). Pregnancy details and outcomes were available through the obstetric caregiver.
MAIN OUTCOME MEASURES: At birth main outcome measures were prematurity (<37 weeks) and birthweight. At follow-up, body mass index (BMI), blood pressure, glucose and lipids were assessed.
RESULTS: SWL occurred in 6.8% of cases. Women with SWL had similar preterm birth rates compared with women without these complaints (adjusted OR 1.1, 95%CI 0.7, 1.7). Birthweight (adjusted difference - 31 g, 95%CI -76, 15) and BMI at 5-6 years of age (adjusted difference 0.2 kg/m(2) , 95%CI 0.0, 0.5) were similar in children born to mothers with SWL and without SWL, but blood pressure was increased. For diastolic blood pressure this association was independent of confounders (adjusted difference 1.4 mmHg, 95%CI 0.4, 2.4). Lipid and glucose levels were not significantly different between these groups.
CONCLUSION: Early pregnancy weight loss, usually occurring as a manifestation of hyperemesis gravidarum, could have long-term consequences for offspring health.
Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands.
Hyperemesis gravidarum and maternal cancer risk, a Scandinavian nested case-control study.
Vandraas KF, Grjibovski AM, Støer NC, Troisi R, Stephansson O, Ording AG, Vangen S, Grotmol T, VikanesÅV
Int J Cancer. 2015;137(5):1209. Epub 2015 Feb 20.
Reproductive factors have been shown to influence cancer risk. Several pathological conditions during pregnancy have also been associated with subsequent altered cancer risk in the mother. Hyperemesis gravidarum (hyperemesis) is an early pregnancy condition characterized by severe nausea and vomiting resulting in weight loss and metabolic disturbances. Studies have reported associations between hyperemesis and cancer, but results are inconsistent. In this nested case-control study we linked the population-based medical birth registries and cancer registries in Norway, Sweden and Denmark in order to examine overall cancer risk and risk of specific cancer types in women with a history of hyperemesis, using conditional logistic regression. In total, 168,501 cases of cancer in addition to up to 10 cancer-free controls per case were randomly sampled, matched on year of birth and birth registry (n = 1,721,626). Hyperemesis was defined through the International Classification of Diseases. Analyses were adjusted for potential confounders. Hyperemesis was inversely associated with overall cancer risk with adjusted relative risk (aRR) of 0.93 (95% CI: 0.88-0.99), with cancer in the lungs (aRR: 0.60, 95% CI: 0.44-0.81), cervix (aRR: 0.66, 95% CI: 0.49-0.91) and rectum (aRR: 0.48, 95% CI: 0.29-0.78). Thyroid cancer was positivelyassociated with hyperemesis (aRR 1.45, 95% CI: 1.06-1.99) and risk increased with more than one hyperemetic pregnancy (aRR 1.80, 95% CI: 1.23-2.63). Hormonal factors, in particular human chorionic gonadotropin, are likely to be involved in mediating these effects. This study is the first to systematically address these associations and provides valuable knowledge on potential long-term consequences of hyperemesis.
Norwegian Advisory Unit for Women'S Health, Oslo University Hospital, Oslo, Norway.