According to "Human Reproduction Update," up to 80 percent of expectant women experience nausea and vomiting during early pregnancy. Mild "morning sickness" does not hurt mother or baby. It may protect the fetus against potentially harmful substances. Severe and persistent morning sickness, also called hyperemesis gravidarum or HG, is another matter. It can threaten your baby's or your own life. HG may cause--and may also be caused by--nutritional deficiencies. Ask your doctor any questions you have about HG, nutrition and malnutrition.
Hyperemesis Gravidarum
According to the July 2010 "Clinical Evidence," HG occurs in 0.5 to 2 percent of live births. The Hyperemesis Education and Research, or HER, Foundation defines HG as "unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids." Potential consequences include malnutrition, dehydration, serious weight loss, urine ketones, blood electrolyte and metabolic imbalances, difficulty with regular activities, cardiovascular disease and disturbed fetal development and growth. Prompt, skilled medical attention can prevent or relieve these serious, even potentially fatal consequences of HG.
Getting and Affording Treatment
Some women with HG feel so miserable, desperate and overwhelmed, they conclude they have no choice but abortion. However, HG has many effective treatments, including but not limited to relatively safe anti-nausea medications and temporary intravenous hydration and nutrition. Although HG treatments are highly individualized, many are aimed at proper nutritional balance. Ask your physician which therapies might work best for you and your baby. If you do not have a doctor, or your doctor is unsympathetic, the HER Foundation has a physician referral network. If you are in the U.S. and cannot afford pregnancy care, visit HealthCare.gov to learn about medical assistance programs.
Possible HG Causes
Some physicians hold onto the historical but unsubstantiated view of HG as arising from the mother's psychological conflicts over pregnancy. According to a 2005 "Human Reproduction Update" literature review, HG most likely has multiple biological causes, especially imbalanced reproductive, thyroid or adrenal cortex hormones. As of July 2011, most but not all nutritional deficiencies have been ruled out as causes of HG.
Nutritional Deficiencies Resulting in HG
By the 1940s, HG patients were known to have insufficient levels of vitamin B-1 or thiamine and B-6 or pyroxidine. Scientists attributed HG to dietary deficiencies of these two vitamins and sometimes used B-1 and B-6 to treat HG. The "Human Reproduction Update" review presents evidence that low B-1 and B-6 result from rather than cause HG. B-6 does not relieve vomiting in pregnant women. Thiamine deficiency in HG resembles that of bulimia or severe starvation. Several researchers associate low copper levels with HG. As of 2011, no studies have yet ruled out copper deficiency--known to disturb the endocrine or hormone-producing system--as a cause of HG.
Nutritional Deficiencies Resulting from HG
Especially when HG is untreated or undertreated, the excessive vomiting and gut malabsorption can themselves result in nutritional deficiencies like those consistently observed for thiamine and pyroxidine. HG-caused lack of vitamin K is linked to late-pregnancy fetal brain hemorrhage. Vitamin supplementation--sometimes by mouth, sometimes intravenous--and other interventions to restore nutritional balance often have roles in HG treatment.
References
- Beyond Morning Sickness: Battling Hyperemesis Gravidarum
- HER Foundation: Hyperemesis Education and Research
- "Human Reproduction Update"; Hyperemesis Gravidarum, A Literature Review; M. Verberg et al.; September-October 2005
- "International Journal of Women's Health"; Optimal Management of Nausea and Vomiting of Pregnancy; N. Ebrahimi et al.; August 2010
- MayoClinic.com; Morning sickness; October 2009
