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Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO Mother-Offspring Cohort Study

Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO Mother-Offspring Cohort Study
Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO Mother-Offspring Cohort Study

Background: Nausea and vomiting of pregnancy (NVP) is common and underlying mechanisms are poorly understood. Longer-term offspring outcomes are also not well documented. This study aimed to determine if NVP, even in milder forms, is associated with adverse pregnancy and childhood growth outcomes. Methods: In the GUSTO prospective mother-offspring cohort, women with singleton pregnancies (n = 1172) recruited in first trimester responded to interviewer-administered questions at 26–28 weeks’ gestation about earlier episodes of NVP since becoming pregnant. Pregnancy outcomes were obtained from medical records. Offspring height and weight measured at 15 time-points between birth to 72 months (m) were standardised for age and sex. Results: 58.5% (n = 686) reported mild-moderate vomiting (mNVP), 10.5% (n = 123) severe vomiting (sNVP) and 5.7% (n = 67) severe vomiting with hospitalisation (shNVP). There was no difference in odds of gestational diabetes, hypertensive disorders of pregnancy, labour induction or caesarean section after adjustment for covariates. sNVP was associated with late preterm delivery [34 + 0–36 + 6 weeks’, adjusted OR = 3.04 (95% CI 1.39,6.68)], without increased odds of neonatal unit admission. Compared with no NVP, boys born to mothers with sNVP were longer at birth [adjusted β = 0.38 standard deviations (SDs) (95% CI 0.02,0.73)], remained taller [0.64 SDs (0.23,1.04) at 72 m] and heavier [0.57 SDs (0.05,1.08) at 60 m] without differences in BMI. Conversely, girls born to mothers with shNVP were lighter from 48 m [− 0.52 SDs (− 1.00, − 0.03)] onwards with lower BMI [− 0.61 SDs (− 1.12,-0.09)]. Conditional growth modelling revealed significant sex-divergence in weight-gain at birth-3 m, 6-9 m and 4–5 years. Conclusions: Severe NVP was associated with late preterm delivery, and both mild-moderate and severe NVP associated with sex-dependent differences in early childhood growth. Boys whose mothers had NVP were taller and heavier from birth with faster growth in the first year, whereas, girls had poorer weight gain and were lighter by 48 m. As even milder severities of NVP could have long-term impact on offspring growth, further research is needed to determine mechanisms involved and implications on future health. Trial registration: Clinicaltrials.gov identifier NCT01174875.

Child anthropometry, Child growth, Hyperemesis gravidarum, Premature birth
1471-2393
Ong, Judith
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Sadananthan, Suresh
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Soh, Shu-E
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Ng, Sharon
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Yuan, Wen Lun
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Aris, I.M.
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Tint, Mya Thway
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Michael, Navin
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Loy, See Ling
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Tan, Kok Hian
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Godfrey, Keith
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Shek, Lynette
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Yap, Fabian
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Lee, Yung Seng
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Chong, Yap-Seng
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Chan, Shiao-Yng
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Ong, Judith
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Sadananthan, Suresh
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Soh, Shu-E
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Ng, Sharon
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Yuan, Wen Lun
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Aris, I.M.
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Tint, Mya Thway
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Michael, Navin
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Loy, See Ling
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Tan, Kok Hian
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Godfrey, Keith
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Shek, Lynette
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Yap, Fabian
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Lee, Yung Seng
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Chong, Yap-Seng
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Chan, Shiao-Yng
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Ong, Judith, Sadananthan, Suresh, Soh, Shu-E, Ng, Sharon, Yuan, Wen Lun, Aris, I.M., Tint, Mya Thway, Michael, Navin, Loy, See Ling, Tan, Kok Hian, Godfrey, Keith, Shek, Lynette, Yap, Fabian, Lee, Yung Seng, Chong, Yap-Seng and Chan, Shiao-Yng (2021) Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO Mother-Offspring Cohort Study. BMC Pregnancy and Childbirth, 21 (1), [578]. (doi:10.1186/s12884-021-04024-9).

Record type: Article

Abstract

Background: Nausea and vomiting of pregnancy (NVP) is common and underlying mechanisms are poorly understood. Longer-term offspring outcomes are also not well documented. This study aimed to determine if NVP, even in milder forms, is associated with adverse pregnancy and childhood growth outcomes. Methods: In the GUSTO prospective mother-offspring cohort, women with singleton pregnancies (n = 1172) recruited in first trimester responded to interviewer-administered questions at 26–28 weeks’ gestation about earlier episodes of NVP since becoming pregnant. Pregnancy outcomes were obtained from medical records. Offspring height and weight measured at 15 time-points between birth to 72 months (m) were standardised for age and sex. Results: 58.5% (n = 686) reported mild-moderate vomiting (mNVP), 10.5% (n = 123) severe vomiting (sNVP) and 5.7% (n = 67) severe vomiting with hospitalisation (shNVP). There was no difference in odds of gestational diabetes, hypertensive disorders of pregnancy, labour induction or caesarean section after adjustment for covariates. sNVP was associated with late preterm delivery [34 + 0–36 + 6 weeks’, adjusted OR = 3.04 (95% CI 1.39,6.68)], without increased odds of neonatal unit admission. Compared with no NVP, boys born to mothers with sNVP were longer at birth [adjusted β = 0.38 standard deviations (SDs) (95% CI 0.02,0.73)], remained taller [0.64 SDs (0.23,1.04) at 72 m] and heavier [0.57 SDs (0.05,1.08) at 60 m] without differences in BMI. Conversely, girls born to mothers with shNVP were lighter from 48 m [− 0.52 SDs (− 1.00, − 0.03)] onwards with lower BMI [− 0.61 SDs (− 1.12,-0.09)]. Conditional growth modelling revealed significant sex-divergence in weight-gain at birth-3 m, 6-9 m and 4–5 years. Conclusions: Severe NVP was associated with late preterm delivery, and both mild-moderate and severe NVP associated with sex-dependent differences in early childhood growth. Boys whose mothers had NVP were taller and heavier from birth with faster growth in the first year, whereas, girls had poorer weight gain and were lighter by 48 m. As even milder severities of NVP could have long-term impact on offspring growth, further research is needed to determine mechanisms involved and implications on future health. Trial registration: Clinicaltrials.gov identifier NCT01174875.

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Accepted/In Press date: 26 May 2021
e-pub ahead of print date: 22 August 2021
Published date: 22 August 2021
Keywords: Child anthropometry, Child growth, Hyperemesis gravidarum, Premature birth

Identifiers

Local EPrints ID: 449697
URI: http://eprints.soton.ac.uk/id/eprint/449697
ISSN: 1471-2393
PURE UUID: 98f621fe-c848-4781-ad06-7dded598396d
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 11 Jun 2021 16:30
Last modified: 07 Oct 2021 04:01

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Contributors

Author: Judith Ong
Author: Suresh Sadananthan
Author: Shu-E Soh
Author: Sharon Ng
Author: Wen Lun Yuan
Author: I.M. Aris
Author: Mya Thway Tint
Author: Navin Michael
Author: See Ling Loy
Author: Kok Hian Tan
Author: Keith Godfrey ORCID iD
Author: Lynette Shek
Author: Fabian Yap
Author: Yung Seng Lee
Author: Yap-Seng Chong
Author: Shiao-Yng Chan

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