Abstract
BackgroundTwo studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Moreover, little information is available on the role of the brain structure in the associations.MethodsIn a US-based cohort, the association was investigated between severe prolonged nausea and vomiting in pregnancy (extending after the second trimester and termed SNVP), psychiatric and cognitive problems, and brain morphology, from the Adolescent Brain Cognitive Development (ABCD) study, from 10,710 children aged 9–11 years. We validated the emotional including psychiatric findings using the Danish National Cohort Study with 2,092,897 participants.ResultsSNVP was significantly associated with emotional and psychiatric problems (t = 8.89, Cohen’s d = 0.172, p = 6.9 × 10−19) and reduced global cognitive performance (t = − 4.34, d = − 0.085, p = 1.4 × 10−5) in children. SNVP was associated with low cortical area and volume, especially in the cingulate cortex, precuneus, and superior medial prefrontal cortex. These lower cortical areas and volumes significantly mediated the relation between SNVP and the psychiatric and cognitive problems in children. In the Danish National Cohort, severe nausea and vomiting in pregnancy were significantly associated with increased risks of behavioral and emotional disorders in children (hazard ratio, 1.24; 95% confidence interval, 1.16–1.33).ConclusionsSNVP is strongly associated with psychiatric and cognitive problems in children, with mediation by brain structure. These associations highlight the clinical importance and potential benefits of the treatment of SNVP, which could reduce the risk of psychiatric disorder in the next generation.
Highlights
Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up
Severe prolonged Nausea and vomiting during pregnancy (NVP) is associated with low volume and area of some cortical regions The total cortical volume and area were significantly lower in the children with exposure to severe nausea and vomiting in pregnancy (SNVP) with t value − 4.02 (Cohen’s d = − 0.08, p = 6.0 × 10−5) and − 3.51 (d = − 0.07, p = 4.4 × 10−4) respectively
The results remained unchanged when restricting analyses to offspring born after 1994 (Additional file 1: Table S8). In this large, nationally representative cohort of 10,710 US children, our findings provide the first evidence that prenatal exposure to prolonged severe nausea and vomiting in pregnancy (SNVP) is associated with a range of psychiatric problems including Attention-deficit/hyperactivity disorders (ADHD) symptoms, and with poor cognitive performance
Summary
Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Severe prolonged NVP correlates closely with vitamin B deficiency, chronic psychological stress, and weight loss [2] These conditions play a crucial role in shaping fetal development and subsequent child brain and behavior development [6,7,8,9]. Anatomical brain abnormalities play a crucial role in children with neurodevelopmental disorders [18, 19] In this context, we performed a large-scale investigation of the association between severe prolonged nausea and vomiting in pregnancy and psychiatric and emotional problems, and brain structure, years later in children. We assessed which brain differences may mediate the effects of severe prolonged NVP on psychiatric and cognitive problems, to potentially understand better what effects severe prolonged NVP may have
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