JBM  Vol.5 No.8 , August 2017
Alteration of Human Chorionic Gonadotropin Levels among Pregnant Women with Morning Sickness Attending Antenatal Care Services at Ishaka Adventist Hospital, Uganda
Abstract: Globally, 50% - 90% of pregnant women are affected by morning sickness of pregnancy, especially during the first trimester. Therefore this study was carried out to establish if there is association between urinary hCG levels and severity of nausea, retching and vomiting among pregnant women attending antenatal care (ANC) services at Ishaka Adventist Hospital (IAH). It was a quantitative cross-sectional study in which a pre-tested and standardized questionnaire with a mixture of both open and closed ended questions was used to collect data from respondents to determine the clinical history, socio-demographic characteristics, and clinical features of morning sickness and/or hyperemesis gravidarum. Urine samples were also collected from each participant and analyzed using the Beckman Coulter Access 2 immunoassay system and Access Total hCG reagent pack at Mbarara University of Science and Technology. The findings showed that 63% of the respondents experienced morning sickness with the majority having a mild form. There was also no significant relationship between hCG levels and severity of morning sickness and no correlation between physiological characteristics (gravidity, age and weight) (correlation coefficient -0.05186, -0.0469 and 0.157 respectively). In addition, there was no correlation between cravings, aversions and morning sickness (correlation coefficient -0.0262 and 0.227 respectively). In conclusion, the study revealed that there was a high prevalence of morning sickness of pregnancy although, it was mild; no association between severity of morning sickness and levels of hCG as well as correlation between cravings and aversions with hCG levels in the study population. Considering the limitations of this study, it is recommended that studies should be undertaken for the quantitative determination of total hCG levels in urine for all pregnant women with morning sickness to be able to draw a definitive conclusion.
Cite this paper: Kasande, A. , Eze, E. , Ezekiel, I. and Rabiu, K. (2017) Alteration of Human Chorionic Gonadotropin Levels among Pregnant Women with Morning Sickness Attending Antenatal Care Services at Ishaka Adventist Hospital, Uganda. Journal of Biosciences and Medicines, 5, 55-77. doi: 10.4236/jbm.2017.58005.

[1]   Flaxman, S.M. and Sherman, P.W. (2000) Morning Sickness, a Mechanism for Protecting Mother and Embryo. The Quarterly Review of Biology, 75, 113-148.

[2]   O’Brien, B. and Zhou, Q. (1995) Variables Related to Nausea and Vomiting during Pregnancy. Birth, 22, 93-100.

[3]   Boneva, R.S., Moore, C.A., Botto, L., Wong, Y. and Erickson, J.D. (1999) Nausea during Pregnancy and Congenital Heart Defects: A Population Based Case Control Study. American Journal of Epidemiology, 149, 717-725.

[4]   Crystal, S.R., Bowen, D.J. and Bernstein, I.L. (1999) Morning Sickness and Salt Intake, Food Craving and Food Aversions. Physiology and Behaviour, 67, 181-187.

[5]   Dodds, L., Fell, D.B., Joseph, K.S., Allen, V.M. and Butler, B. (2006) Outcomes of Pregnancies Complicated by Hyperemesis Gravidarum. Obstetrics and Gynaecology, 107, 285-292.

[6]   Zhang, J. and Cai, W.W. (1991) Severe Vomiting during Pregnancy: Antenatal Correlation and Fetal Outcomes. Epidemiology, 2, 454-457.

[7]   Tsang, S., Katz, V.L. and Wells, S.D. (1996) Maternal and Fetal Outcomes in Hyperemesis Gravidarum. International Journal of Gynaecology and Obstetrics, 55, 231-235.

[8]   Gadsby, R., Barnie-Adshead, A.M. and Jagger, C. (1997) Pregnancy Nausea Related to Women’s Obstetric and Personal Histories. Gynaecologic and Obstetric Investigation, 43, 108-111.

[9]   Smith, C., Crowther, C., Beilly, J. and Dandeaux, J. (2000) The Impact of Nausea and Vomiting on Women: A Burden of Early Pregnancy. Australian and New Zealand Journal of Obstetric Gynaecology, 40, 397-400.

[10]   Baird, D.D., Weinberg, C.R., McConnaughey, D.R. and Wilcox, A.J. (2003) Rescue of the Corpus Luteum in Human Pregnancy. Biology of Reproduction, 68, 448-456.

[11]   Grün, J.P., Meuris, S., De Nayer, P. and Glinoer, D. (1997) The Thyrotrophic Role of Human Chorionic Gonadotrophin (hCG) in the Early Stages of Twin (Versus Single) Pregnancies. Clinical Endocrinology, 46, 719-725.

[12]   Perrier d’Hauterive, S., Berndt, S., Tsampalas, M., Charlet-Renard, C., Dubois, M., Bourgain, C., Hazout, A., Foidart, J.M. and Geenen, V. (2007) Dialogue between Blastocyst hCG and Endometrial LH/hCG Receptor: Which Role in Implantation? Gynecologic Obstetric Investigation, 64, 156-160.

[13]   Goodwin, T.M., Hershman, J.M. and Cole, L. (1994) Increased Concentration of Free β Subunit of Human Chorionic Gonadotropin in Hyperemesis Gravidarum. Acta Obstetricia et Gynecologica Scandinavica, 73, 770-772.

[14]   Goodwin, T.M., Poursharif, B., Korst, L.M., MacGibbon, K. and Fejzo, M.S. (2002) Hormone Profile of Kuwaiti Women with Hyperemesis Gravidarum. Obstetrics and Gynecology, 266, 218-222.

[15]   Jordan, V., Grebe, S.K.G., Cooke, R.R., Ford, H.C., Larsen, P.D., Stone, P.R. and Salmond, C.E. (1999) Acidic Isoforms of Chorionic Gonaditrophin in European and Samoan Women Are Associated with Hyperemesis Gravidarum and May Be Thyrotrophic. Clinical Endocrinology, 50, 619-627.

[16]   Al-Yatama, M., Diejomaoh, M., Nanda Kumaran, M., Monem, R.A., Omu. A.E. and Al Kandari, F. (2002) Hormone Profile of Kuwaiti Women with Hyperemesis Gravidarum. Archives Gynecology and Obstetrics, 266, 218-222.

[17]   O’Connor, K.A., Holman, D.J., Miller, R.C., Barsom, S.H. and Wood, J.W. (2004) Pregnancy Related Sickness in Rural Bangladesh: Symptoms and Their Links with Reproductive Hormones. Human Reproduction, CSDE Working Paper No. 04-07, CSDE, University of Washington, Washington DC.

[18]   Krejcie, R.V. and Morgan, D.W. (1970) Determining Sample Size for Research Activities. Educational and Psychological Measurement, 30, 607-610.

[19]   Gadsby, R., Barnie-Adhead, A.M. and Jagger, C. (1993) A Prospective Study of Nausea and Vomiting during Pregnancy. British Journal of General Practice, 43, 245-248.

[20]   Kallen, B., Lunderg, G. and Aberg, A. (2003) Relationship between Vitamin Use, Smoking and Nausea and Vomiting of Pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 82, 916-920.

[21]   Lacroix, R., Eason, E. and Mel Zack, R. (2000) Nausea and Vomiting during Pregnancy: A Prospective Study of Its Frequency, Intensity and Patterns of Change. American Journal of obstetrics Gynecology, 182, 931-937.

[22]   Simeons, A.T.W (2010) Pounds and Inches: A New Approach to Obesity.

[23]   Kris-Etherton, P.M., Harris, W.S. and Appel, L.J. (2002) Fish Consumption, Oil Fish, Omega-3-Fatty Acids and Cardiovascular Disease. Circulation, 106, 2747-2757.

[24]   Hibbein, J.R., Davis, J.M. and Steer, C. (2007) Maternal Seafood Consumption in Pregnancy and Neuro-Developmental Outcomes in Childhood (ALSPAC Study): An Observational Cohort Study. Lancet, 309, 578-585.

[25]   Oken, E., Wright, R.O. and Weinman, K.P. (2005) Maternal Fish Consumption, Hair Mercury and Infant Cognition in a U.S Cohort. Environmental Health Perspective, 113, 1376-1380.

[26]   Demissie, T., Muroki, N. and Goi-Makau, W. (1998) Food Aversions and Cravings during Pregnancy: Prevalence and Significance for Maternal Nutrition in Ethiopia. Food and Nutrition Bulletin, 19, 20-26.

[27]   Cahill, L. and McGaugh, J.L. (1996) Modulation of Memory Storage. Current Opinion in Neurobiology, 6, 237-242.

[28]   Addis, D.R., Moscovitch, M., Crawley, A.P. and McAndrews, M.P. (2004) Re-Collective Qualities Modulate Hippocampal Activation during Autobiographical Memory Retreval. Hippocampus, 14, 752-762.