Examining the genetic relationship between nausea and vomiting in pregnancy, anxiety and depression

Nausea and vomiting in pregnancy (NVP) is an extremely commoncondition in pregnancy with global prevalence of 70%. NVP can progress tohyperemesis gravidarium, present in 1% pregnancies, defined as persistent andexcessive... [ view full abstract ]

Nausea and vomiting in pregnancy (NVP) is an extremely commoncondition in pregnancy with global prevalence of 70%. NVP can progress tohyperemesis gravidarium, present in 1% pregnancies, defined as persistent andexcessive vomiting, with dehydration, ketonuria and >5% bodyweight loss. NVPmay affect the psychosocial functioning of affected women. There is anincreased prevalence of major depressive disorder and anxiety prior topregnancy among women with severe NVP and NVP is a risk factor of postnataldepression.

The relationship between NVP,depression and anxiety is compatible with a shared liability arising fromshared genetic factors. The aim of this study is to test this hypothesis byestimating the genetic correlations between this conditions.

The NVP Genetics Consortium isa collaborative project that aims to identify the causes of NVP and hyperemesisgravidarum and the factors explaining the relationship of NVP with psychiatrictraits. We have conducted a GWAS meta-analysis on  27,631 women from participating cohorts (QIMR,Australia; MTR, Spain; ALSPAC, United Kigdom; EGCUT, Estonia), which iscurrently underpowered.

We used LD-score to estimatethe genetic correlations between NVP (results from the NVP Consortium),depression (MDD, results of the Psychiatric Genomics Consortium MajorDepressive Disorder 2018) and anxiety (ANX, ANGST consortium 2016).Additionally, we estimated rg with post-traumatic stress disorder (PTSD, PsychiatricGenomics Consortium 2017) and schizophrenia (SCZ, Psychiatric Genomics Consortium2014).

MDD and ANX may share geneticrisk, with variants increasing the severity of NVP increasing the risk for MDD(rg=0.28, p=0.08) and ANX (rg=0.27, p= 0.06). NVP does not seem to begenetically related to SCZ (rg -0.03, p=0.70) or PTSD (rg= -0.39, p=0.23).

The identification of geneticvariants having a pleiotropic effect in NVP and depression will clarify the mechanismby which these traits co-occur, and help identify biological pathways that caninform new treatments. This information may also allow medical professionals toassess the need for increased monitoring of NVP in pregnant women with ahistory of depression.