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Severe hyperemesis gravidarum is associated with reduced insulin sensitivity in the offspring in childhood

Ahila Ayyavoo1, José G B Derraik, Paul L Hofman

  • 1Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.

The Journal of Clinical Endocrinology and Metabolism
|June 11, 2013
PubMed

Insights

Children born to mothers with severe hyperemesis gravidarum (SHG) exhibit reduced insulin sensitivity. This finding suggests a potential increased long-term risk for metabolic diseases like diabetes mellitus in these offspring.

Area of Science:

  • Reproductive Medicine
  • Pediatric Endocrinology
  • Metabolic Health

Background:

  • Severe hyperemesis gravidarum (SHG) impacts maternal and fetal nutrition during pregnancy.
  • Limited data exist on the long-term metabolic consequences for offspring following maternal SHG.
  • This study investigates the effects of SHG on childhood glucose homeostasis and body composition.

Purpose of the Study:

  • To assess the impact of severe hyperemesis gravidarum (SHG) on offspring glucose homeostasis.
  • To evaluate the long-term effects of SHG on offspring body composition in childhood.
  • To determine if maternal SHG influences key metabolic markers in children.

Main Methods:

  • A cohort study comparing prepubertal children (4-11 years) born to mothers with SHG (n=36) versus control pregnancies (n=42).
  • Insulin sensitivity was measured using intravenous glucose tolerance tests and Bergman's minimal model.
  • Additional assessments included lipid profiles, hormonal levels, and body composition via dual-energy x-ray absorptiometry.

Main Results:

  • Offspring of mothers with SHG demonstrated 20% lower insulin sensitivity compared to controls (P=.014).
  • SHG offspring exhibited higher fasting insulin (P=.024) and lower IGF binding protein 1 (P=.004) levels.
  • Elevated baseline cortisol concentrations were observed in SHG offspring (P=.021), despite similar anthropometrics.

Conclusions:

  • Children exposed to severe hyperemesis gravidarum in utero show impaired insulin sensitivity.
  • This reduced insulin sensitivity may elevate the future risk of developing type 2 diabetes mellitus.
  • Longitudinal follow-up of SHG offspring is crucial for assessing long-term metabolic disease risk.
Abstract

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