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Researchers Identify the Cause of Morning Sickness

Researchers in Nature identified a hormonal basis for morning sickness, providing a potential way to assess risk.

On December 13, 2023, scientists published a study in Nature that identified a risk factor for morning sickness, also called hyperemesis gravidarum. The condition causes severe nausea and vomiting during early pregnancy.

“For the first time, hyperemesis gravidarum could be addressed at the root cause, rather than merely alleviating its symptoms,” Tito Borner, a physiologist at the University of Pennsylvania, told Nature.

The study leaders looked at GDF15, a hormone that has been linked to nausea and vomiting during pregnancy. Based on their conclusions, the hormone, produced in small doses by the prostate, bladder, kidneys, and other organs, acts on receptors in the brainstem, triggering nausea and vomiting. Ingesting potentially dangerous substances and early pregnancy may be linked to elevated hormone production.

The researchers theorized that GDF15 was evolutionarily advantageous because it helped protect humans from poisoning and the fetus during pregnancy. Understanding the correlation, the researchers evaluated GDF15 levels in pregnant women.

Based on data from 120 women, half of whom did not experience morning sickness and the other half who did experience morning sickness, they determined that GDF15 levels are significantly higher in patients who experience hyperemesis gravidarum.

A deeper dive into the condition revealed that some genetic variations that reduced the baseline production of GDF15 were linked to a higher risk of hyperemesis gravidarum. A genetic data analysis of 18,000 people with higher GDF15 rates before pregnancy showed they were less likely to experience morning sickness once pregnant. Researchers confirmed this finding with a mouse model.

Based on the hypothesized pathophysiology of hyperemesis gravidarum, the investigators predict that administering GDF15 to patients trying to conceive may minimize their risk of morning sickness.

“We now have a clear view of what may cause this problem and a route for both treatment and prevention,” said study co-author Stephen O’Rahilly, a metabolism researcher at the University of Cambridge, UK, in an interview with Nature.

Despite optimism from researchers, more data is needed to establish the role of GDF15 in preventing morning sickness.

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