Department of Obstetrics and Gynecology, Shiseikai-daini Hospital, Tokyo, 157-8550, Japan.
Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Medical Center East, Tokyo 116-8567, Japan.
Nutrients. 2020 Jun 3;12(6):1664. doi: 10.3390/nu12061664.
The epigenetic impact of malnutrition in mothers with hyperemesis gravidarum (HG) on their offspring has not been fully elucidated. Recently, several reports have demonstrated that children born to mothers with HG were small for gestational age and had low birth weight, reduced insulin sensitivity, and neurodevelopmental delays during childhood. Therefore, we examined the relationship between fetal growth and changes in the maternal body weight in HG cases. A total of 34 patients with HG were hospitalized and delivered at term between 2009 and 2012. The records of 69 cases of pregnant women without a history of HG were extracted after matching their maternal age, parity, pregestational body mass index (BMI), gestational age, and fetal sex ratio with those of the HG group for comparison. The maternal weight gain at term was less in the HG than in the control group. There was no statistical difference in birth weight, placental weight, and ultrasonic fetometric parameters expressed in standard deviation (SD) scores, including biparietal diameter, abdominal circumference, and femur length, between the HG and the control group. Whereas fetal head growth in the HG group was positively associated with maternal weight gain at 20 weeks of gestation only, this association was not observed in the control group. We herein demonstrate that maternal weight gain from the nadir is associated with fetal head growth at mid-gestation. Thus, maternal undernutrition in the first trimester of pregnancy could affect fetal brain growth and development, leading to an increased risk of neurodevelopmental delays in later life.
母亲在妊娠剧吐（HG）中营养不良对后代的表观遗传影响尚未完全阐明。最近，有几项报告表明，HG 母亲所生的孩子出生体重低，胰岛素敏感性降低，儿童时期神经发育迟缓。因此，我们研究了 HG 病例中胎儿生长和母体体重变化之间的关系。共有 34 名 HG 患者在 2009 年至 2012 年期间足月住院分娩。在与 HG 组的母亲年龄、产次、孕前体重指数（BMI）、孕龄和胎儿性别比例相匹配后，提取了 69 例无 HG 病史的孕妇的记录进行比较。HG 组的足月体重增加少于对照组。HG 组与对照组在出生体重、胎盘重量和超声胎儿测量参数（用标准差（SD）评分表示），包括双顶径、腹围和股骨长度方面无统计学差异。而 HG 组胎儿头部生长仅与 20 周妊娠时的母体体重增加呈正相关，对照组则无此相关性。我们在此证明，从最低点开始的母体体重增加与妊娠中期的胎儿头部生长有关。因此，妊娠早期的母体营养不良可能会影响胎儿大脑的生长和发育，导致日后神经发育迟缓的风险增加。
