Severe hyperemesis gravidarum is associated with reduced insulin sensitivity in the offspring in childhood

J Clin Endocrinol Metab. 2013 Aug;98(8):3263-8. doi: 10.1210/jc.2013-2043. Epub 2013 Jun 7.

Abstract

Background: Hyperemesis gravidarum alters maternal (and possibly fetal) nutrition throughout pregnancy, but there are no data on long-term effects on offspring metabolism. Thus, we aimed to assess whether severe hyperemesis gravidarum (SHG) affects glucose homeostasis and body composition in the offspring in childhood.

Methods: Healthy prepubertal children (aged 4-11 years) born at term were studied: offspring of mothers who were admitted to hospital with SHG (n = 36) and offspring of mothers from control pregnancies (n = 42). Primary outcome was insulin sensitivity measured using iv glucose tolerance tests and Bergman's minimal model. Other assessments included lipid and hormonal profiles and body composition using whole-body dual-energy x-ray absorptiometry.

Results: Insulin sensitivity in SHG children was 20% lower than in controls (8.49 vs 10.60 × 10(-4)·min(-1)·(mU/L); P = .014). SHG children also had higher fasting insulin (6.88 vs 5.04 mIU/L; P = .024) and lower IGF binding protein 1 (11.8 vs 19.0 ng/mL; P = .004) concentrations than controls. Baseline cortisol concentrations were 22% higher in SHG offspring (256 vs 210 nmol/L; P = .021). Children in both groups were anthropometrically similar.

Conclusion: Children born to mothers who experienced SHG have lower insulin sensitivity, which may increase their long-term risk of developing diabetes mellitus. Follow-up of SHG offspring is essential to determine later risk of metabolic disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Composition
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 2 / etiology
  • Female
  • Glucose / metabolism*
  • Homeostasis
  • Humans
  • Hydrocortisone / blood
  • Hyperemesis Gravidarum / complications
  • Hyperemesis Gravidarum / metabolism*
  • Insulin Resistance*
  • Male
  • Pregnancy

Substances

  • Glucose
  • Hydrocortisone