Do you want to learn more about hyperemesis gravidarum (HG)? Our team at the HER Foundation wanted to answer the Internet’s most searched questions regarding HG. Responding to common questions like, “Will hyperemesis harm my baby?” and clearing up misconceptions like, “Why does HG cause ketonuria?,” we’re here to clarify the conversation surrounding hyperemesis.
- What is HG?
HG is hyperemesis gravidarum: a potentially life-threatening pregnancy disease that may cause weight loss, malnutrition, dehydration, and debility due to severe nausea and vomiting, and may cause long-term health issues for mom and baby. (It’s also sometimes called pregnancy sickness, hg disease, or hg syndrome. It’s more than severe morning sickness.)
- Does HG increase risk of miscarriage?
While weight loss is a common symptom of HG, minor weight loss during this first trimester should not put the baby at significant risk. However, if the mother does not receive adequate treatment and continues to lose weight and become malnourished, the risk of miscarriage can increase. The longer and more severe the weight loss, malnutrition and dehydration, the greater the risk of miscarriage.
- Does hyperemesis gravidarum affect the baby?
HG typically does not cause serious complications to most children during fetal development, unless the mother has severe or prolonged malnutrition. Aggressive and early management of HG to prevent weight loss and stress on mother and child are the best ways to prevent complications of HG. Treatments for HG are found to have little if any impact on the baby’s growth and development even when given in early pregnancy.
Studies do show that severe, prolonged or inadequately treated HG can have lifelong consequences for affected children postpartum. Children exposed to HG in utero have shown increased rates of autism spectrum disorder. They also experience a 3.28-fold increase in the probability of receiving a neurodevelopmental diagnosis, including attention disorders, learning delay, sensory processing disorders, and speech and language delay. Additionally, affected children have demonstrated an increased risk of psychological and behavioral disorders in adulthood, such as depression, bipolar disorder, and anxiety. This is thought to be due to the effects of poor nutrition and stress on the child. Other studies on famine during early pregnancy suggest possible long-term cardiac and metabolic disorders. More research is needed to confirm this in HG. (Note: Research grants for HG are extremely rare so please support HG research!)
- Does hyperemesis go away?
In most women, symptoms will begin within 4-6 weeks after conception. The nausea/vomiting will often ease after the first trimester and resolves by 20 weeks in about half of women. However, about 10-20% of mothers will find nausea and vomiting last until delivery, though it is usually less severe. If you have had HG in previous pregnancies, it will often follow a similar pattern of duration and severity. In some women, there is a trend towards more severe symptoms in each subsequent pregnancy.
- Why does HG cause ketonuria?
Ketonuria is the presence of ketones in urine. Ketones are produced when the body is starving and uses fat versus carbohydrates as fuel. Ketones do not always correlate with weight loss or symptom severity. They may not reliably occur in all women who are not eating due to HG, and thus are not a criteria for diagnosis or treatment of HG. They do, however, predict a longer duration of hospitalization.
Some studies suggest ketones may be harmful to the baby, and women with ketones often will receive IV fluids with vitamins. Women who cannot eat and lose more than 5-10% of their body weight generally need nutritional support.
- Does hyperemesis happen with every pregnancy?
Studies vary, but most find that 70-80% of women have a good chance of experiencing HG again in future pregnancies. Those with more than one HG pregnancy have a greater risk of re-experiencing HG. It also may occur in similar patterns and severity, or worsen each time, though it is not always consistent. Those who have mothers, grandmothers, or sisters who have had HG will often have some nausea and vomiting during pregnancy, and have a high probability of HG due to their genes.
Occasionally, a woman with a history of HG will have a pregnancy without HG. A woman may also have HG after several pregnancies without HG. Preparation is key.