The Duchess of Cambridge, Princess Kate went through an exhausting early pregnancy for her royal children, Princess Charlotte and Prince George. Her bouts with morning sickness are not new to more than 50 percent of pregnant women today who also suffer from it. The American Pregnancy Association explained.
Even pregnant women who watched their diet from organic to non-GMO also went through this miserable phase. While those who did not even pay attention to what they eat did not languish in nausea, loss of appetite, and vomiting coupled with countless bathroom visits. Situations varied from one pregnant woman to another. APA said that various factors are being incriminated for this predicament from rising hormone levels to slow food digestion and the mothers’ innate ability to protect the baby from dangerous toxins.
According to Jose De La Mota, a board-certified OBGYN, Sharp Rees-Stealy Medical Group, 90 percent of pregnant women suffer from nausea. And that morning sickness is considered a normal part of pregnancy.
However, about 3 percent of the strata do suffer from a severe form of morning sickness, the formal name of which is hyperemesis gravidarum or HG. Scientists are puzzled over this mystery. How this particular condition affects certain pregnant women while others are not is not known.
At the Onset of Pregnancy
Dramatic hormonal changes happen during the first few weeks of a woman’s pregnancy. The first obvious sign of pregnancy is morning sickness. This is the nausea and vomiting experienced by some in the morning and at other times of the day by other pregnant women. Morning sickness appears from the first up to the third month of pregnancy. As the hormones stabilize, this condition becomes less frequent. The intensity and duration of the nausea differ from one pregnant woman to another.
According to Dr. De La Mota, symptoms of morning sickness can start between four and six weeks of pregnancy, peak at about nine weeks, and will usually resolve during the first trimester. However, some patients may experience symptoms until the third trimester, and close to 5 percent of women will have them until delivery.
At the same time, many pregnant women would experience disgust over some food or dishes, or a particular scent. A Cornell University study actually explained this aversion as a protective instinct of the mother to protect the fetus. Food cravings are normal too.
Pregnant women who go through the condition are advised to eat small meals several times all throughout the day. Fatty and deep-fried food should be avoided and replaced by oatmeal, yogurt, fruits, and nuts.
In the morning, pregnant women are also advised to manage nausea upon waking up. A piece of saltine cracker can be placed beside the bed and eaten as soon as the expectant mother awakens to soothe the tummy. Sometimes, when vomiting is too overpowering, it is also recommended to drink ginger ale, soda water, peppermint or tea blends to calm the stomach. Throughout the day, it is important to consume fluids as often as possible to replace fluids due to vomiting every morning.
The Opposing View
Researchers from University of California, Los Angeles and University of Southern California, in partnership with 23andMe, discovered the genes responsible for extreme nausea and vomiting of pregnant women or hyperemesis gravidarum during early pregnancy.
This condition that causes distress to 3 percent of pregnant women is also accountable for weight loss and electrolyte disruption. Some pregnant women suffer from the mild condition and are advised on dietary adjustments, antacids, and rest. But those with a severe condition necessitate IV fluids or feeding tubes to replenish those lost from the body. Unfortunately, the current medications to treat HG are inadequate and could escalate to serious health consequences for the mother and the unborn baby. On the whole, HG remains the second topmost reason for hospitalization of pregnant mothers today.
The study published in the journal Nature Communications identified the genes known as GDF15 and IGFBP7. These two genes are also crucial in early pregnancy, appetite regulation and the development of the placenta.
"It has long been assumed that the pregnancy hormones, human chorionic gonadotropin or estrogen, were the likely culprits of extreme nausea and vomiting, but our study found no evidence to support this," said Marlena Fejzo, the study's first author and an associate researcher at the David Geffen School of Medicine, UCLA. She further explained that these two genes are also linked to cachexia, a general physical wasting and malnutrition usually associated with chronic disease. Cachexia symptoms resemble that of HG. It is also responsible for 20 percent of deaths among cancer patients. In fact, Fejzo herself suffered from hyperemesis gravidarum which resulted in a lost pregnancy in 1999.
Research done in the past showed that hyperemesis gravidarum is hereditary and gave the impression that genetics is the culprit, that this condition runs in the family. However, the research gleaned a different conclusion.
The research team compared the DNA variation of non-HG pregnant women with HG-affected pregnant women. The research discovered that DNA variations around the genes, GDF15 and IGFBP7, were connected to hyperemesis gravidarum. These findings were confirmed and revalidated in an independent study of women with hyperemesis gravidarum.
The researchers evaluated the DNA of 1,306 women of European ancestry who indicated in an online survey that they underwent IV therapy for nausea and vomiting during pregnancy. The data was compared against 15,756 women participants who did not suffer from the condition while pregnant.
Results from this group showed a direct correlation between severe morning sickness and the genes GDF15 and IGFBP7. Researchers also looked into the symptom data of 50,000 female customers who consented to participate in the research.
Though the results are yet to be picked up by the pharmaceutical industry, "It is my hope that one day a medication that affects this pathway will be used to successfully treat and possibly cure hyperemesis gravidarum," Fejzo stressed.
[researchpaper 리서치페이퍼=Kay Yeban 기자]