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Recurrence of hyperemesis across generations

BMJ 2010; 340 doi: (Published 29 April 2010) Cite this as: BMJ 2010;340:c2178
  1. Catherine Nelson-Piercy, consultant obstetric physician
  1. 1Guy’s and St Thomas’ Foundation Trust, London SE1 7EH
  1. catherine.nelson-piercy{at}

    Daughters of affected mothers have a three times higher risk

    Hyperemesis gravidarum is responsible for recurrent admissions to hospital, causes much psychological distress, is associated with increased maternal and fetal morbidity, and is potentially fatal. In the linked population based cohort study from the Norwegian birth registry (doi:10.1136/bmj.c2050), Vikanes and colleagues show that daughters born to mothers who have had hyperemesis in any pregnancy have a three times higher risk of having a pregnancy complicated by hyperemesis than women born to mothers who have never had hyperemesis.1

    At least half of pregnant women experience nausea and vomiting.2 At the extreme end of the spectrum are women whose symptoms are so severe or so prolonged that they lose weight and develop dehydration and ketosis. This condition, hyperemesis gravidarum, affects 0.5-1% of pregnancies, but the causes are not fully understood.2

    Maternal complications as a result of inadequately treated hyperemesis include vitamin deficiencies, such as B1 (thiamine) deficiency causing Wernicke’s encephalopathy; electrolyte abnormalities, such as severe hypokalaemia and hyponatraemia, which may cause central pontine myelinolysis3; venous thromboembolism related to dehydration and immobility; aspiration and oesophageal tears; protein and energy malnutrition; and psychological morbidity. Fetal …

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