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The nutritional consequences of pregnancy sickness

A critique of a hypothesis

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Abstract

The purpose of this paper is to assess Profet’s (1992) and others’ hypothesis that nausea and vomiting in pregnancy (NVP) is adaptive. A number of studies have found an association between NVP and a decreased risk for early fetal loss (<20 weeks). It is assumed that the adaptive benefits of improved survivorship associated with NVP outweigh the minimal nutritional consequences. However, in populations that experience marginal levels of nutrition, NVP may have important nutritional consequences. To test these potential consequences, a study on NVP, nutritional status, and pregnancy outcome was conducted among Turkana pastoralists, who experience seasonal and chronic nutritional stress. Interviews and anthropometric assessments were conducted on 68 pregnant Turkana women of Kenya during a 1993–1994 field season. The results from the case study suggest that women who experience NVP do encounter nutritional consequences in the later stages of pregnancy and are more likely to experience poor pregnancy outcomes. These results suggest that NVP may not be adaptive in all environmental settings, particularly among marginally nourished populations.

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References

  • Adair, L. S. 1987 Nutrition during the Reproductive Years. In Nutritional Anthropology, F. E. Johnston, ed. Pp. 119–154. New York: Alan R. Liss.

    Google Scholar 

  • Adair, L. S., and E. Pollitt 1983 Seasonal Variation in Pre- and Postpartum Maternal Body Measurements and Infant Birthweights. American Journal of Physical Anthropology 62:325–331.

    Article  Google Scholar 

  • 1985 Outcome of Maternal Nutritional Supplementation: A Comprehensive Review of the Bacon Chow Study. American Journal of Clinical Nutrition 41:948–978.

    Google Scholar 

  • Adair, L. S., E. Pollitt, and W. H. Mueller 1984 The Bacon Chow Study: Effect of Nutritional Supplementation on Maternal Weight and Skinfold Thicknesses during Pregnancy and Lactation. British Journal of Nutrition 51:357–369.

    Article  Google Scholar 

  • Allen, L. H., M. S. Lung’aho, M. Shaheen, G. G. Harrison, C. Neumann, and A. Kirksey 1994 Maternal Body Mass Index and Pregnancy Outcome in the Nutrition Collaborative Research Support Program. European Journal of Clinical Nutrition 48:s68–77.

    Google Scholar 

  • Anderson, M., and K. Krasovec 1991 Introduction. In Maternal Nutrition and Pregnancy Outcome: Anthropometric Assessment, K. Krasovec and M. Anderson, eds. Pp. 1–28. Washington, D.C.: Pan American Health Organization.

    Google Scholar 

  • Andersson, R., and S. Bergstrom 1995 Use of Fundal Height as a Proxy for Length of Gestation in Rural Africa. Journal of Tropical Medicine and Hygiene 98:169–172.

    Google Scholar 

  • Barker, D. J. P., P. D. Gluckman, K. M. Godfrey, J. E. Harding, J. A. Owens, and J. S. Robinson 1993 Fetal Nutrition and Cardiovascular Disease in Adult Life. Lancet 341:938–1001.

    Article  Google Scholar 

  • Behrman, C. A., M. L. Hediger, T. O. Scholl, and C. M. Arkangel 1990 Nausea and Vomiting during Teenage Pregnancy: Effects on Birth Weight. Journal of Adolescent Health Care 11:418–422.

    Article  Google Scholar 

  • Brandes, J. M. 1967 First-Trimester Nausea and Vomiting as Related to Outcome of Pregnancy. Obstetrics and Gynecology 30:427–431.

    Google Scholar 

  • Christofides, N., M. Ghatei, S. Bloom, C. Borberg, and M. Gillmer 1982 Decreased Plasma Motilin Concentrations in Pregnancy. British Medical Journal 285:1453–1454.

    Article  Google Scholar 

  • Denver, R. 1997 Environmental Stress as a Developmental Cue: Corticotropin-Releasing Hormone Is a Proximate Mediator of Adaptive Phenotypic Plasticity in Amphibian Metamorphosis. Hormones and Behavior 31:169–179.

    Article  Google Scholar 

  • Dodic, M., A. Peers, J. P. Coghlan, and M. Wintour 1999 Can Excess Glucocorticoid, in Utero, Predispose to Cardiovascular and Metabolic Disease in Middle Age? Trends in Endocrinology and Metabolism 10:86–91.

    Article  Google Scholar 

  • Dubowitz, L., and V. Dubowitz 1977 Gestational Age of the Newborn. Reading: Addison-Wesley.

    Google Scholar 

  • Dubowitz, L., V. Dubowitz, and C. Goldberg 1970 Clinical Assessment of the Gestational Age of the Newborn Infant. Journal of Pediatrics 77:1–10.

    Article  Google Scholar 

  • Fairweather, D. V. I. 1965 Nausea and Vomiting in Pregnancy. American Journal of Obstetrics and Gynecology 102:135–175.

    Google Scholar 

  • Fitzgerald, K. M. 1984 Nausea and Vomiting in Pregnancy. British Journal of Medical Psychology 57:159–165.

    Google Scholar 

  • Foley, R. A. 1993 The Influence of Seasonality on Hominid Behavior. In Human Ecology and Seasonality, S. J. Ulijaszek and S. S. Strickland, eds. Pp. 17–37. Cambridge: Cambridge University Press.

    Google Scholar 

  • Frisch, R. 1987 Body Fat, Menarche, Fitness and Fertility. Human Reproduction 2:521–533.

    Google Scholar 

  • Gadsby, R., A. M. Barnie-Adshead, and C. Jagger 1993 A Prospective Study of Nausea and Vomiting during Pregnancy. British Journal of General Practice 43:245–288.

    Google Scholar 

  • Galvin, K. A. 1985 Food Procurement, Diet, Activities and Nutrition of Ngisonyoka, Turkana Pastoralists in an Ecological and Social Context. Ph.D. dissertation, State University of New York at Binghamton. Ann Arbor: University Microfilms.

    Google Scholar 

  • 1992 Nutritional Ecology of Pastoralists of Dry Tropical Africa. American Journal of Human Biology 4:209–221.

    Article  Google Scholar 

  • Galvin, K. A., and M. A. Little 1999 Dietary Intake and Nutritional Status. In Turkana Herders of the Dry Savanna, Ecology and Biobehavioral Response of Nomads to an Uncertain Environment, M. Little and P. Leslie, eds. Pp. 125–146. Oxford: Oxford University Press.

    Google Scholar 

  • Galvin, K. A., D. L. Coppock, and P. W. Leslie 1994 Diet, Nutrition, and the Pastoral Strategy. In African Pastoral Systems: An Integrated Approach, E. Fratkin, K. Galvin, and E. Roth, eds. Pp. 113–132. Boulder: Lynne Reiner.

    Google Scholar 

  • Gonzalez-Cossio, T., and H. Delgado 1991 Functional Consequences of Maternal Malnutrition. World Review of Nutrition and Dietetics 64:139–173.

    Google Scholar 

  • Grabowski, C. T. 1983 Human Reproduction and Development. Philadelphia: Saunders.

    Google Scholar 

  • Hook, E. B. 1976 Changes in Tobacco Smoking and Ingestion of Alcohol and Caffeinated Beverages during Early Pregnancy: Are These Consequences, in Part, of Feto-protective Mechanisms Diminishing Maternal Exposure to Embryotoxins? In Birth Defects: Risks and Consequences, S. Kelly, E. B. Hook, D. T. Janerich, and I. H. Porter, eds. Pp. 173–183. New York: Academic Press.

    Google Scholar 

  • Indira, R., A. Oumachigui, K. A. Narayam, P. Rajaram, and G. Ramalingam 1990 Symphisus-Fundal Height Measurement: A Reliable Parameter for Fetal Growth Assessment. International Journal of Gynecology and Obstetrics 33:1–6.

    Article  Google Scholar 

  • Institute of Medicine 1990 Nutrition during Pregnancy. Washington, D.C.: National Academy Press.

    Google Scholar 

  • Jarnfelt-Samsioe, A., G. Samsioe, and G. Velinder 1983 Nausea and Vomiting in Pregnancy—A Contribution to Its Epidemiology. Gynecology and Obstetric Investigations 16:221–229.

    Google Scholar 

  • Jarnfelt-Samsioe, A., B. Eriksson, J. Waldenstrom, and G. Samsioe 1985 Some New Aspects on Emesis Gravidarum. Relations to Clinical Data, Serum Electrolytes, Total Protein and Creatinine. Gynecology and Obstetric Investigations 19:174–186.

    Article  Google Scholar 

  • Jarnfelt-Samsioe, A., K. Bremme, and P. Eneroth 1986a Non-steroid Hormones and Tissue Polypeptide Antigen (TPA) in Emetic and Non-emetic Pregnancy. Acta Obstetrica Gynecologia Scandinavica 65:745–751.

    Google Scholar 

  • 1986b Steroid Hormones in Emetic and Non-emetic Pregnancy. European Journal of Obstetrics, Gynecology and Reproductive Biology 21:87–99.

    Article  Google Scholar 

  • Jelliffe, D., and I. Maddocks 1964 Notes on Ecological Malnutrition in the New Guinea Highlands. Clinics in Pediatrics 3:432–438.

    Google Scholar 

  • Kelly, A., J. Kevany, M. de Onis, and P. M. Shah 1997 A WHO Collaborative Study of Maternal Anthropometry and Pregnancy Outcomes. International Journal of Gynecology and Obstetrics 57:1–15.

    Article  Google Scholar 

  • Klebanoff, M. A., P. A. Koslowe, R. Koslowe, and G. C. Rhoads 1985 Epidemiology of Vomiting in Early Pregnancy. Obstetrics and Gynecology 66:612–616.

    Google Scholar 

  • Kramer, M. S. 1987 Determinants of Low Birth Weight: Methodological Assessment and Meta-analysis. Bulletin of the World Health Organization 65:663–737.

    Google Scholar 

  • Krasovec, K. 1991 Prepregnancy Weight: Background Issues. In Maternal Nutrition and Pregnancy Outcome: Anthropometric Assessment, K. Krasovec and M. Anderson, eds. Pp. 59–68. Washington, D.C.: Pan American Health Organization.

    Google Scholar 

  • Lawoyin, T. O. 1991 Maternal Weight and Weight Gain in Africans: Its Relationship to Birth Weight. Journal of Tropical Pediatrics 37:166–171.

    Google Scholar 

  • Leslie, P. W., and E. A. Lowoto 1990 Turkana Event Calendar. In South Turkana Ecosystem Project: Report to the Government of Kenya, M. A. Little and P. W. Leslie, eds. Appendix. Nairobi: Office of the President.

    Google Scholar 

  • Leslie, P. W., J. Bindon, and P. T. Baker 1984 Caloric Requirements of Human Populations: A Model. Human Ecology 12:137–162.

    Article  Google Scholar 

  • Leslie, P. W., K. L. Campbell, M. A. Little, and C. S. Kigondu 1996 Evaluation of Reproductive Function in Nomadic and Settled Women of Turkana, Kenya. Human Biology 65:237–254.

    Google Scholar 

  • Little, M. A. 1989 Human Biology of African Pastoralists. Yearbook of Physical Anthropology 32:215–247.

    Article  Google Scholar 

  • Little, M. A., K. A. Galvin, and M. Mugambi 1983 Cross-sectional Growth of Nomadic Turkana Pastoralists. Human Biology 55:811–830.

    Google Scholar 

  • Little, M. A., S. J. Gray, I. L. Pike, and M. Mugambi 1999 Infant, Child, and Adolescent Growth, and Adult Physical Status. In Turkana Herders of the Dry Savanna: Ecology and Biobehavioral Response of Nomads to an Uncertain Environment, M. Little and P. Leslie, eds. Pp. 187–206. Oxford: Oxford University Press.

    Google Scholar 

  • Little, M., P. Leslie, and K. Campbell 1992 Energy Reserves and Parity of Nomadic and Settled Turkana Women. American Journal of Human Biology 4:729–738.

    Article  Google Scholar 

  • Little, R. E. 1980 Maternal Alcohol and Tobacco Use and Nausea and Vomiting during Pregnancy: Relation to Infant Birthweight. Acta Obstetrica Gynecologica Scandinavica 59:495–497.

    Article  Google Scholar 

  • Lohman, T. G., A. F. Roche, and R. Martorell 1988 Anthropometric Standardization Reference Manual. Champaign: Human Kinetics Books.

    Google Scholar 

  • Masson, G. M., F. Anthony, and E. Chau 1985 Serum chorionic gonadotrophin (hCG), schwangerschaftsprotein 1 (SP1), Progesterone and Oestradiol Levels in Patients with Nausea and Vomiting in Early Pregnancy. British Journal of Obstetrics and Gynecology 92:211–215.

    Google Scholar 

  • McLean, M., and R. Smith 1999 Corticotropin-Releasing Hormone in Human Pregnancy and Parturition. Trends in Endocrinology and Metabolism 10:174–178.

    Article  Google Scholar 

  • McLean, M., A. Bisits, J. Davies, R. Woods, P. Lowry, and R. Smith 1995 A Placental Clock Controlling the Length of Human Pregnancy. Nature Medicine 1:460–463.

    Article  Google Scholar 

  • McCormick, M. C. 1985 The Contribution of Low Birth Weight to Infant Mortality and Childhood Mortality. New England Journal of Medicine 312:82–90.

    Article  Google Scholar 

  • Medalie, J. H. 1957 Relationship between Nausea and/or Vomiting in Early Pregnancy and Abortion. Lancet 2:117–119.

    Article  Google Scholar 

  • Milkovich, L., and B. J. van den Berg 1976 An Evaluation of the Teratogenicity of Certain Antinauseant Drugs. American Journal of Obstetrics and Gynecology 125:244.

    Google Scholar 

  • Minturn, L., and A. W. Weiher 1984 The Influence of Diet on Morning Sickness: A Cross-Cultural Study. Medical Anthropology 8:71–75.

    Article  Google Scholar 

  • O’Connor, K. 1999 Pregnancy Sickness: Using Your Body’s Natural Defenses to Protect Your Baby-to-Be, by Margie Profet. American Journal of Physical Anthropology 108:377–379.

    Article  Google Scholar 

  • O’Connor, K., D. Holman, E. Brindle, S. Barsom, and J. W. Wood 1998 Reproductive Hormones and Pregnancy-Related Sickness in a Prospective Study of Bangladeshi Women. American Journal of Physical Anthropology 105:172.

    Google Scholar 

  • Pebley, A. R., L. Huffman, A. K. M. Chowdhury, and O. W. Stupp 1985 Intrauterine Mortality and Maternal Nutritional Status in Rural Bangladesh. Population Studies 39:440.

    Article  Google Scholar 

  • Petitti, D. B. 1986 Nausea and Pregnancy Outcome. Birth 13:223–226.

    Article  Google Scholar 

  • Phillips, D. I. W., and D. J. P. Barker 1997 Association between Low Birthweight and High Resting Pulse in Adult Life: Is the Sympathetic Nervous System Involved in Programming of the Insulin Resistance Syndrome? Diabetes Medicine 14:673–677.

    Article  Google Scholar 

  • Phillips, D. W., D. P. Barker, C. D. Fall, J. R. Seckl, C. B. Whorwood, P. J. Wood, and B. R. Walker 1998 Elevated Plasma Cortisol Concentrations: A Link between Low Birth Weight and the Insulin Resistance Syndrome? Journal of Clinical Endocrinology and Metabolism 83:757–760.

    Article  Google Scholar 

  • Pike, I. L. 1999 Age, Reproductive History, Seasonality and Maternal Body Composition During Pregnancy for Turkana Women of Kenya. American Journal Human Biology 11:658–672.

    Article  Google Scholar 

  • n.d Pregnancy Outcome for Turkana Women of Kenya. American Journal Physical Anthropology, in press

  • Prentice, A. M., T. J. Cole, F. A. Foord, W. H. Lamb, and R. G. Whitehead 1987 Increased Birthweight after Prenatal Dietary Supplementation of Rural African Women. American Journal Clinical Nutrition 46:912–925.

    Google Scholar 

  • Profet, M. 1988 The Evolution of Pregnancy Sickness as Protection to the Embryo against Pleistocene Teratogens. Evolutionary Theory 8:177–190.

    Google Scholar 

  • 1992 Pregnancy Sickness as Adaptation: A Deterrent to Maternal Ingestion of Teratogens. In The Adapted Mind: Evolutionary Psychology and the Generation of Culture, J. H. Barkow, L. Cosmides, and J. Tooby, eds. Pp. 327–365. New York: Oxford University Press.

    Google Scholar 

  • Scholl, T. O., and M. L. Hediger 1995 Weight Gain, Nutrition, and Pregnancy Outcome: Findings from the Camden Study of Teenage and Minority Gravidas. Seminars in Perinatology 19:171–181.

    Article  Google Scholar 

  • Scholl, T. O., M. L. Hediger, I. G. Ances, D. H. Belsky, and R. W. Salmon 1990 Weight Gain during Pregnancy in Adolescence: Predictive Ability of Early Weight Gain. Obstetrics and Gynecology 75:948–953.

    Google Scholar 

  • Siega-Riz, A. M., and L. S. Adair 1993 Biological Determinants of Pregnancy Weight Gain in a Filipino Population. American Journal Clinical Nutrition 57:365–372.

    Google Scholar 

  • Siega-Riz, A. M., L. S. Adair, and C. J. Hobel 1996 Maternal Underweight Status and Inadequate Rate of Weight Gain during the Third Trimester of Pregnancy Increases Risk of Preterm Delivery. Journal of Nutrition 126:146–153.

    Google Scholar 

  • Sokal, R. R., and F. J. Rohlf 1995 Biometry: The Principles and Practice of Statistics in Biological Research, third ed. New York: W.H. Freeman.

    Google Scholar 

  • Soules, M., C. J. Hughes, J. Garcia, C. Livergood, M. Prystowsky, and E. Alexander 1980 Nausea and Vomiting of Pregnancy: Role of Human Chorionic Gonadotropin and 17-hydroxy-progesterone. Obstetrics and Gynecology 55:696–700.

    Google Scholar 

  • Tierson, F. D., C. L. Olsen, and E. B. Hook 1986 Nausea and Vomiting of Pregnancy and Association with Pregnancy Outcome. American Journal of Obstetrics and Gynecology 155:1017–1022.

    Google Scholar 

  • Vellacott, I. D., E. J. Cooke, and C. E. James 1988 Nausea and Vomiting in Early Pregnancy. International Journal of Gynecology and Obstetrics 27:57–62.

    Article  Google Scholar 

  • Villar, J., M. J. Khoury, F. F. Finucane, and H. Delgado 1986 Differences in the Epidemiology of Prematurity and Intrauterine Growth Retardation. Early Human Development 14:307–320.

    Article  Google Scholar 

  • Walker, A. R. P., B. F. Walker, J. Jones, M. Verardi, and C. Walker 1985 Nausea and Vomiting and Dietary Cravings and Aversions during Pregnancy in South African Women. British Journal of Obstetrics and Gynecology 92:484–489.

    Google Scholar 

  • Weigel, M. M., and R. M. Weigel 1988 The Association of Reproductive History, Demographic Factors, and Alcohol and Tobacco Consumption with the Risk of Developing Nausea and Vomiting in Early Pregnancy. American Journal of Epidemiology 127:562–570.

    Google Scholar 

  • 1989 Nausea and Vomiting of Early Pregnancy and Pregnancy Outcome. An Epidemiological Study. British Journal of Obstetrics and Gynecology 96:1304–1311.

    Google Scholar 

  • Weigel, R. M., and M. M. Weigel 1989 Nausea and Vomiting of Early Pregnancy and Pregnancy Outcome. A Meta-analytical Review. British Journal of Obstetrics and Gynecology 96:1312–1318.

    Google Scholar 

  • Wood, J. W. 1994 Dynamics of Human Reproduction: Biology, Biometry, Demography. Hawthorne, New York: Aldine de Gruyter.

    Google Scholar 

  • Yerushalmy, J., and L. Milkovich 1965 Evaluation of the Teratogenic Effects of Meclizine in Man. American Journal of Obstetrics and Gynecology 93:553–562.

    Google Scholar 

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  1. Department of Anthropology, Ohio State University, 115 Lord Hall, 124 W. 17th Ave, 43210, Columbus, OH

    I. L. Pike

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Correspondence to I. L. Pike.

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Financial support for the Turkana study was provided by a dissertation fellowship from The Population Council, Wenner-Gren Foundation, and NSF grants BNS-8718477, and DBS-9207837.

Ivy L. Pike, Ph.D., is an Assistant Professor of Anthropology at Ohio State University. Her research interests include the evolutionary and ecological context of health, nutrition, and reproduction. She has conducted research among Turkana women of Kenya and is initiating a project among the Iraqw, an agro-pastoral population of Tanzania.

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Pike, I.L. The nutritional consequences of pregnancy sickness. Hum Nat 11, 207–232 (2000). https://doi.org/10.1007/s12110-000-1011-5

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