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July 2009Volume 155, Issue 1, Pages 45–50.e2
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Long-term Neurodevelopment of Children Exposed to Maternal Nausea and Vomiting of Pregnancy and Diclectin

Irena Nulman
x
Irena Nulman
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Correspondence

  • Reprint requests: Dr Irena Nulman, Department of Clinical Pharmacology, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.
, MD'Correspondence information about the author MD Irena Nulman
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Irena Nulman
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Correspondence

  • Reprint requests: Dr Irena Nulman, Department of Clinical Pharmacology, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.
,
Joanne Rovet
x
Joanne Rovet
, PhD
,
Maru Barrera
x
Maru Barrera
, PhD
,
Dafna Knittel-Keren
x
Dafna Knittel-Keren
, MA
,
Brian M. Feldman
x
Brian M. Feldman
, MD
,
Gideon Koren
x
Gideon Koren
, MD
Hospital for Sick Children, Toronto, Ontario, Canada
Long-term Neurodevelopment of Children Exposed to Maternal Nausea and Vomiting of Pregnancy and Diclectin
DOI: http://dx.doi.org/10.1016/j.jpeds.2009.02.005

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Objective

To determine the effects of nausea and vomiting of pregnancy (NVP) and its treatment with diclectin on child neurodevelopment.

Study design

An observational cohort study of mother-child pairs ascertained via a pregnancy call-in center was conducted. Three groups of children were studied: 45 with NVP and diclectin, 47 with NVP no diclectin, and 29 with no NVP. Phone calls to mothers during pregnancy and 6 to 9 months after childbirth yielded information on pregnancy, birth, and early child development. Children aged 3 to 7 years received a comprehensive set of psychological tests. Mothers were assessed for IQ and socioeconomic status.

Results

All children scored in the normal range for IQ, with the NVP-exposed group scoring higher than the non-exposed group on Performance IQ (P < .02), NEPSY Verbal Fluency (P < .003) and Phonological Processing (P < .004), and McCarthy Numerical Memory (P < .004). Predictors of enhanced results were NVP severity and maternal IQ.

Conclusions

NVP has an enhancing effect on later child outcome. Diclectin does not appear to adversely affect fetal brain development and can be used to control NVP when clinically indicated.

CBCL (Child Behavior Checklist), CES-D (Center for Epidemiologic Studies Depressed Mood Scale), FSIQ (Full-scale IQ), HG (Hyperemesis gravidarum), HSC (Hospital for Sick Children), NVP (Nausea and vomiting of pregnancy), PIQ (Performance IQ), PUQE (Pregnancy-unique quantification of emesis and nausea), SES (Socioeconomic status), VIQ (Verbal IQ), WASI (Wechsler Abbreviated Scale of Intelligence), WPPSI (Wechsler Preschool and Primary Scale of Intelligence), WRAVMA (Wide Range Assessment of Visual Motor Abilities)

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Supported by Duchesnay (Laval, Quebec). G.K. has served as a paid consultant for Duchesnay. G.K. and I.N. hold a CIHR Collaborative grant with Duchesnay.

© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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