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Hyperemesis gravidarum and the risk of offspring morbidity: a longitudinal cohort study
Nathalie Auger1,2,3,4, Banmeet Padda5, Philippe Bégin5,6,7
1University of Montreal Hospital Research Centre, Montreal, QC, Canada. nathalie.auger@inspq.qc.ca.
Insights
Maternal hyperemesis gravidarum (HG) increases the risk of childhood hospitalization. Children exposed to HG showed higher rates of hospitalization for neurologic, developmental, digestive, and allergic conditions.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Epidemiology
Background:
- Hyperemesis gravidarum (HG) is linked to neurodevelopmental issues in offspring, but its impact on other childhood morbidities remains unclear.
- This study investigates the association between maternal HG and a broader spectrum of childhood health outcomes.
Purpose of the Study:
- To examine the association between maternal hyperemesis gravidarum and the risk of hospitalization for childhood morbidity.
- To determine if maternal HG impacts long-term health outcomes in children.
Main Methods:
- A longitudinal cohort study of 1,189,000 children born in Quebec, Canada (2006-2021).
- Exposure defined as maternal hyperemesis gravidarum requiring hospitalization in the first or second trimester.
- Outcome assessed as any pediatric admission up to 16 years of age, analyzed using Cox regression models.
Main Results:
- Maternal hyperemesis gravidarum was associated with a 1.21 times greater risk of any hospitalization before age 16.
- Increased hospitalization risk was observed for neurologic (HR 1.50), developmental (HR 1.51), digestive (HR 1.40), and allergic disorders (HR 1.39).
- Hyperemesis gravidarum was a stronger risk factor for these outcomes compared to preeclampsia.
Conclusions:
- Maternal hyperemesis gravidarum is linked to an elevated risk of childhood hospitalization.
- The association is particularly notable for neurologic, developmental, digestive, and atopic disorders.
- These findings highlight the potential long-term health implications of HG for offspring.
Purpose:
Hyperemesis gravidarum has the potential to affect the long-term health of offspring. We examined whether maternal hyperemesis gravidarum was associated with the risk of hospitalization for childhood morbidity.
Methods:
We conducted a longitudinal cohort study of 1,189,000 children born in Quebec, Canada, between April 2006 and March 2021. The main exposure measure was maternal hyperemesis gravidarum requiring hospitalization in the first or second trimester. The outcome was any pediatric admission between birth and 16 years of age, with follow-up ending in March 2022. We used Cox regression models adjusted for maternal and socioeconomic factors to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal hyperemesis gravidarum and childhood hospitalization.
Results:
Among 1,189,000 children, 6904 (0.6%) were exposed to maternal hyperemesis gravidarum. Hospitalization rates at age 16 years were higher for children exposed to hyperemesis gravidarum than unexposed children (47.6 vs 43.9 per 100 children). Relative to no exposure, hyperemesis gravidarum was associated with a 1.21 times greater risk of any hospitalization before 16 years (95% CI 1.17-1.26). Hyperemesis gravidarum was associated with hospitalization for neurologic (HR 1.50, 95% CI 1.32-1.71), developmental (HR 1.51, 95% CI 1.29-1.76), digestive (HR 1.40, 95% CI 1.30-1.52), and allergic disorders (HR 1.39, 95% CI 1.24-1.56). When contrasted with preeclampsia, hyperemesis gravidarum was a stronger risk factor for these outcomes.
Conclusions:
Maternal hyperemesis gravidarum is associated with an increased risk of childhood hospitalization, especially for neurologic, developmental, digestive, and atopic disorders.
What Is Known:
• Hyperemesis gravidarum is associated with neurodevelopmental disorders in offspring. • However, the effect of hyperemesis gravidarum on other childhood morbidity is unclear.
What Is New:
• In this longitudinal cohort study of 1.2 million children, maternal hyperemesis gravidarum was associated with a greater risk of hospitalization before age 16 years. • Exposure to hyperemesis gravidarum was associated with developmental, neurologic, atopic, and digestive morbidity in childhood.
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