Hypermesis gravadarum is a severe form of morning sickness that affects about 1-2% of pregnant women. This condition causes extreme nausea, vomiting and dehydration, which can lead to weight loss, electrolyte imbalances, malnutrition and sometimes loss of the baby.
In recent decades, researchers have worked to identify causes, risk factors, and possible treatments. Studies have shown that hormonal imbalances, genetic factors, and underlying medical conditions may contribute to the debilitating condition.
This week researchers at University of Cambridge published a new study that sheds light on the science behind the disease. The guilty? A hormone called GDF15, produced by the fetus.
The severity of pregnancy sickness depends both on the amount of GDF15 produced by the fetus and on the mother’s exposure to this hormone before becoming pregnant. However, this discovery offers hope for prevention by exposing mothers to GDF15 before pregnancy to boost their resilience.
Nausea and vomiting during pregnancy affects up to 70% of women. In a small percentage, between 1 and 3 in 100 pregnancies, it can be severe enough to threaten the life of the mother and fetus, requiring hospitalization and intravenous fluid replacement.
While there are some existing treatments to treat pregnancy sickness, many women do not receive adequate treatment due to lack of awareness and fear of using medication during pregnancy.
Until recently, the cause of pregnancy sickness was unknown. However, placental production of GDF15 has recently been identified as a possible cause. Now, an international study involving scientists from the University of Cambridge and other research institutions has made significant progress in understanding the role of GDF15 in pregnancy disease, including severe cases.
Researchers analyzed data from women who took part in a number of studies, including those at University Hospitals Cambridge NHS Foundation Trust and North West Anglia NHS Foundation Trust. They used a combination of approaches, including human genetics, hormone measurements, and studies in cells and mice.
The study found that the amount of nausea and vomiting pregnant women experience is directly related to the levels of GDF15 produced by the placenta and released into their bloodstream, as well as their sensitivity to the hormone’s nausea.
GDF15 is usually produced at low levels outside of pregnancy. Hormone sensitivity during pregnancy is influenced by previous exposure to it. Women with low levels of GDF15 have a higher risk of developing severe pregnancy disease. Conversely, women with a genetic variant associated with hyperemesis gravidarum or the blood disorder beta thalassemia, which results in high levels of GDF15 before pregnancy, have a reduced risk of nausea and vomiting.
Professor Sir Stephen O’Rahilly, who led the study, said understanding the role of GDF15 in pregnancy disease provides information for prevention strategies. The researchers believe that preventing GDF15 from accessing its receptor in the mother’s brain could form the basis of an effective and safe treatment.
Initial experiments in mice showed promising results. Mice exposed to high levels of GDF15 showed loss of appetite, indicating nausea. However, when mice were treated with a long-acting form of GDF15, they did not exhibit similar behavior when exposed to acute levels of the hormone. This suggests that developing tolerance to GDF15 before pregnancy could be the key to preventing the disease.
Dr. Marlena Fejzo, co-author of the study, has personal experience with hyperemesis gravidarum and emphasizes the need for more research into this common but poorly understood condition.
“Hopefully, now that we understand the cause of hyperemesis, we are one step closer to developing effective treatments to stop other mothers going through what I and many other women have experienced.” Doctor Fejzo said.
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