Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis

M V E Veenendaal, A F M van Abeelen, R C Painter, J A M van der Post, T J Roseboom
BJOG: An International Journal of Obstetrics and Gynaecology 2011, 118 (11): 1302-13

BACKGROUND: There is evidence that hyperemesis gravidarum (HG) is associated with a predominance of female fetuses, lower birthweights and shorter gestational ages at birth. As the adverse effects of prematurity and low birthweight on disease risk in later life have become increasingly clear, the repercussions of HG might not be limited to adverse perinatal outcomes.

OBJECTIVES: To summarise the evidence on short- and long-term outcomes of pregnancies with HG.

SEARCH STRATEGY: A literature search was conducted in the electronic databases Medline and Embase.

SELECTION CRITERIA: Studies were included that reported on the fetal, neonatal and long-term outcome of pregnancies complicated by HG.

DATA COLLECTION AND ANALYSIS: Two authors independently selected studies and extracted data. Meta-analysis was performed using review manager.

MAIN RESULTS: Women with HG during pregnancy were more likely to have a female child (OR 1.27; 95% CI 1.21-1.34). They were also more likely to have a baby with low birthweight (LBW, <2500 kg; OR 1.42; 95% CI 1.27-1.58) that was small for gestational age (SGA; OR 1.28; 95% CI 1.02-1.60), and to deliver prematurely (OR 1.32; 95% CI 1.04-1.68). There was no association with Apgar scores, congenital anomalies or perinatal death. One study described an association between HG and testicular cancer in the offspring.

AUTHOR'S CONCLUSIONS: There is evidence that HG is associated with a higher female/male ratio of offspring and a higher incidence of LBW, SGA and premature babies. Little is known about the long-term health effects of babies born to mothers whose pregnancies were complicated by HG.

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