Does nutritional deficiency exist in women with severe hyperemesis gravidarum and contribute towards adverse metabolic outcomes

Melanie Nana; Caroline Ovadia; Hannah Ebdon; Argyro Syngelaki; Xi Yang; Catherine Nelson-Piercy; Kypros Nicolaides; Catherine Williamson

doi:10.1530/endoabs.109.P161

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Endocrine Abstracts (2025) 109 P161 | DOI: 10.1530/endoabs.109.P161

SFEBES2025 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Does nutritional deficiency exist in women with severe hyperemesis gravidarum and contribute towards adverse metabolic outcomes

Melanie Nana ¹ , Caroline Ovadia ¹ , Hannah Ebdon ² , Argyro Syngelaki ³ , Xi Yang ³ , Catherine Nelson-Piercy ¹ , Kypros Nicolaides ³ & Catherine Williamson ²

Author affiliations

¹Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom; ²Imperial College London, London, United Kingdom; ³King’s College London, London, United Kingdom

Background: Hyperemesis Gravidarum (HG) describes severe nausea and vomiting in pregnancy resulting from increased pregnancy hormones (notably hCG and GDF-15). Children born to women with severe HG have increased risk of subsequent cardiometabolic disease. We hypothesis that this may relate to a period of catch-up growth in growth restricted babies secondary to maternal nutrient deficiency.

Aims: a) describe HG-associated fetal outcomes in a UK population b) determine whether nutrient status is associated with adverse outcomes.

Methods: CogStack, a Natural Language Processing system, identified severe HG-pregnancies between 2011-2023. HG-patients were compared to controls using data and stored samples from a non-intervention screening study. First trimester nutrient assays were performed at the Cambridge Nutritional Biomarker Laboratory and correlated with adverse outcomes.

Results: Cogstack identified 2741 patients with the term ‘hyperemesis’ on their hospital electronic record system. 881 were confirmed to have severe HG after review of their hospital records and were compared to 54,045 women from the background South-East London population. HG-women were more likely to be of black ethnicity compared to white (39.2% vs 17.0%, P < 0.00001); no differences in age, body mass index, parity or past medical history were determined. HG-pregnancies were associated with fetal growth restriction (FGR) (18.0% vs 12.1%, P = <0.00001) in all ethnicities. Differences in gestational diabetes rates were not found. HG-patients had lower vitamin B6 (38.2 vs 16.6nmol/l, P < 0.001), 25(OH)D3 (58.8 vs 42.9nmol/l (<0.001), fat-soluble vitamin concentrations ((lutein and zeaxanthin (0.58 vs 0.45, P < 0.001) and b-carotene (0.93 vs 0.72, P = 0.005)). Linear regression revealed that low iron (P < 0.01), vitamin B6 (P = 0.02), vitamin D (P < 0.0001) and fat-soluble vitamin concentrations (both P = 0.02) correlated with FGR.

Conclusion: This is the first study to correlate nutrient status in HG-women with adverse outcomes. Future work will focus on nutrient status and outcomes with respect to endocrine parameters, ethnicity and birthweight.