Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children
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RESEARCH ARTICLE
Open Access
Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children Hui Wang1†, Edmund T. Rolls2,4,5†, Xiujuan Du1, Jingnan Du2, Dexin Yang2, Jiong Li1,6, Fei Li1*, Wei Cheng2,3* and Jianfeng Feng2,3,4
Abstract Background: Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Moreover, little information is available on the role of the brain structure in the associations. Methods: In a US-based cohort, the association was investigated between severe prolonged nausea and vomiting in pregnancy (extending after the second trimester and termed SNVP), psychiatric and cognitive problems, and brain morphology, from the Adolescent Brain Cognitive Development (ABCD) study, from 10,710 children aged 9–11 years. We validated the emotional including psychiatric findings using the Danish National Cohort Study with 2,092,897 participants. Results: SNVP was significantly associated with emotional and psychiatric problems (t = 8.89, Cohen’s d = 0.172, p = 6.9 × 10−19) and reduced global cognitive performance (t = − 4.34, d = − 0.085, p = 1.4 × 10−5) in children. SNVP was associated with low cortical area and volume, especially in the cingulate cortex, precuneus, and superior medial prefrontal cortex. These lower cortical areas and volumes significantly mediated the relation between SNVP and the psychiatric and cognitive problems in children. In the Danish National Cohort, severe nausea and vomiting in pregnancy were significantly associated with increased risks of behavioral and emotional disorders in children (hazard ratio, 1.24; 95% confidence interval, 1.16–1.33). Conclusions: SNVP is strongly associated with psychiatric and cognitive problems in children, with mediation by brain structure. These associations highlight the clinical importance and potential benefits of the treatment of SNVP, which could reduce the risk of psychiatric disorder in the next generation. Keywords: Nausea and vomiting, Cognitive performance, Psychiatric problems, Cortical structure, Cingulate cortex, Precuneus, Superior medial prefrontal cortex
* Correspondence: [email protected]; [email protected] † Hui Wang and Edmund T. Rolls contributed equally to the study and considered are the co-first authors. 1 Department of Developmental and Behavioral Pediatric & Child Primary Care/MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China 2 Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long a
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