Autonomic and Enteric Nervous System Dysfunction May Play a Role in Hyperemesis Gravidarum

Joy D. Hughes, Neeta G. Nayak, Naeem Aslam, Hani Rashed, Sergio Cardoso, Babajide Familoni, James G. Karas, David C. Shaver, Robert S. Egerman, Alan Wallstedt, Caroline A. Reily, Thomas L. Abell


Background: Nausea and vomiting, seen in 70-85% of all pregnancies, becomes intractable in hyperemesis gravidarum (HG). We aimed to investigate the relationship between HG and autonomic nervous system functioning and gastric electrical activity.

Methods: Twenty-seven pregnant patients, 21 with HG and six normal, were studied with sympathetic adrenergic; percent vasoconstriction (%VC) and postural adjustment ratio (PAR); parasympathetic vagal cholinergic functions by R-to-R intervals (RRIs), a total autonomic score; and enteric nervous system measured by electrogastrography (EGG).

Results: Significant differences were found in parasympathetic measures (RRI for HG 29.98 2.95 vs. control 40.91 2.38, P < 0.05); sympathetic PAR was significantly lower in patients (PAR for HG 24.5 5.0 vs. 67.6 11.4 for controls, P < 0.01); mean total autonomic score was significantly lower in HG (131.75 9.61 vs. 196.87 12.8, P < 0.05). EGG results were borderline different (normal < 3.3, HG 3.4 vs. controls 3.0, P = 0.07).

Conclusion: Autonomic and enteric nervous system dysfunction may play a role in the pathophysiology of HG.

Gastroenterol Res. 2015;8(1):153-156


Nausea and vomiting; Hyperemesis gravidarum; Pregnancy; Weight loss; Autonomic nervous system; Enteric nervous system

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