Abstract
PurposePrenatal sub-optimal nutrition and exposure to maternal stress, anxiety and depression in pregnancy have been linked to increased postnatal morbidity and mortality. Fetal growth is most vulnerable to maternal dietary deficiencies, such as those evident in hyperemesis gravidarum (HG), early in pregnancy. The purpose of this pilot study was to examine the effects of HG on fetal movement profiles as a measure of fetal healthy development in the 3rd trimester of pregnancy, and to assess whether nutritional stress on the mother can be evaluated using isotopic analysis of hair.MethodWe analyzed fetal movement profiles using 4D ultrasound scans at 32- and 36-weeks' gestation. Fetuses of women (N = 6) diagnosed with HG, having lost more than 10% of their body weight in the first trimester of pregnancy were compared to a healthy group (N = 6), controlling for stress, depression and anxiety. We tested carbon and nitrogen isotope ratios in maternal hair as a measure of both diet and nutritional changes due to catabolism of body proteins and fats.ResultsHG and catabolism were significantly correlated (p = 0.02). Furthermore, at 32-weeks' gestation movement profiles of fetuses of mothers with HG differed significantly from the movement profiles of fetuses of healthy mothers. Fetuses of mothers suffering from HG showed a significantly increased ratio of fine-grained movements at 32 weeks (p = 0.008); however, there were no significant differences detectable at 36-weeks' gestation.ConclusionThe effect of HG on fetal development as expressed by variations in fetal movement profiles in this pilot study suggest that prenatal effects of HG can be measured using movement profiles. Isotope analysis of hair can supplement this with information on nutritional imbalances early in pregnancy.
Highlights
Nutritional stress and pregnancy outcomesSuboptimal nutrition and maternal mental health during pregnancy have been linked to increased infant morbidity and mortality [1, 2]
Given that only offspring from mothers who had a poor diet during the pregnancy caused by Hyperemesis gravidarum (HG) rather than their siblings brought up in the same environment showed negative emotional and behavioural effects, it seems likely that the negative effects are caused by HG and that HG has long-term consequences lasting into adulthood
We examined fetal movement profiles of two groups of mothers, six mothers who had suffered HG and six healthy mothers, using 4D ultrasound scans recorded at 32- and 36-weeks’ gestation
Summary
Nutritional stress and pregnancy outcomesSuboptimal nutrition and maternal mental health during pregnancy have been linked to increased infant morbidity and mortality [1, 2]. Maternal mental health (stress, anxiety and depression) has been identified as a significant prenatal factor predicting postnatal development [4, 5]. Where there is a lack of balanced nutrition, and maternal mental ill-health, it may severely affect fetal neuro-behavioural development [1]. HG is defined by weight loss through excessive vomiting during pregnancy and plays a significant role in health outcomes [9, 10]. These effects are long term, in that in utero exposure to HG is significantly associated with poor postnatal mental health outcomes for the child [10]. Given that only offspring from mothers who had a poor diet during the pregnancy caused by HG rather than their siblings brought up in the same environment showed negative emotional and behavioural effects, it seems likely that the negative effects are caused by HG and that HG has long-term consequences lasting into adulthood
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