Introduction:
A study published in Nature indicates that morning sickness in pregnant women is linked to a hormone that mothers are exposed to through the placenta, helping to answer an age-old medical question and raises the possibility of alleviating this common ailment by exposing patients to the same hormone before pregnancy.
Key Facts:
The hormone known as growth differentiation factor 15 (GDF15) is a protein produced by humans throughout their lives and sends signals to the part of the brain responsible for appetite and nausea, and it is abundant in the mother’s placenta. The severity of morning sickness in women is directly related to the amount of GDF15 produced by the fetus – which increases as the pregnancy progresses – and the mother’s sensitivity to the nausea-inducing effects of the hormone, which is influenced by the amount of GDF15 that the mother is exposed to before pregnancy, according to the study led by the University of Cambridge and published on Wednesday.
Although all humans produce GDF15, factors such as age, intense exercise, cancer, smoking, and certain medications like the diabetic drug metformin are known to increase GDF15 levels.
Morning sickness is very common – affecting between 70% to 80% of pregnant women – but the exact cause has not been known, although some previously believed that low blood sugar and hormonal imbalances could be the culprits.
Researchers at the University of Cambridge believe that continuous exposure to GDF15 may reduce the risk of developing a severe form of morning sickness known as hyperemesis gravidarum (HG): they tested this theory by injecting GDF15 into mice and found that mice previously exposed to the hormone reduced their chances of developing HG by nearly 50% compared to the control group.
Women who carry a rare mutation in GDF15 called C211G have a 10-fold increased risk of developing HG because the mutation reduces GDF15 levels before pregnancy, increasing the risk of HG during pregnancy.
What to Watch For:
Clinical trials are currently underway using metformin as a means to boost GDF15 levels in women before pregnancy, according to researchers at the University of Cambridge. Metformin increases GDF15 levels in diabetic patients by about 2.5% after two weeks of use, according to a study published in Nature in 2020.
Main Background:
A study published earlier this year that is awaiting peer review found that elevated levels of GDF15 in the placenta are associated with severe morning sickness such as HG. However, Wednesday’s study is the first peer-reviewed study to find that increased exposure to GDF15 before pregnancy can significantly reduce morning sickness. HG is the most severe and rare form of morning sickness, affecting between 0.3% and 10.8% of all pregnancies, according to a study published in Frontiers in Medicine. The condition is linked to preterm birth and low birth weight, causing severe nausea, vomiting, weight loss, and electrolyte imbalance, and can lead to hospitalization, according to the American Pregnancy Association. Symptoms usually appear between the fourth and sixth weeks of pregnancy, peaking between the ninth and thirteenth weeks. The disorder can be hereditary and happens in many pregnancies.
Additional Information:
Researchers at the University of Cambridge believe that the high concentration of GDF15 in the placenta may serve the purpose of preventing women from consuming foods containing teratogenic substances – anything ingested or exposed to during pregnancy known to cause fetal abnormalities – or infectious agents during the early stages of pregnancy. More than 90% of women report experiencing food aversions during early pregnancy, primarily related to meats and alkaline beverages, according to O’Rahilly. While this may have helped safeguard the mother and infant during early developmental stages, it does not serve much purpose now with modern food production.
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