Hyperemesis gravidarum: decades of neglect, GDF15 hope

Research indicating a greater than 70% reduction in hyperemesis gravidarum (HG) risk with metformin arrives after years of neglect, from late-19th/early-20th-century case reports and the thalidomide (Distaval) era of the 1950s–1960s to Kate Middleton’s 2012 hospitalisation and, by June 2025, studies centred on GDF15 biology.

HG affects up to 3% of pregnant women worldwide and may reach 11% in parts of China; unlike routine first-trimester nausea, excessive vomiting can persist throughout pregnancy, with dehydration, starvation, isolation and minimal protocols affecting mother and baby.

Historical literature—Victorian British Medical Journals and the American Journal of Obstetrics and Diseases of Women and Children—details severe, sometimes fatal cases and disparate interventions: surgical “emptying the uterus” with Bossi’s dilator, mercury and laudanum, “rectal alimentation,” cocaine in “heroic doses,” electric shock, radiotherapy and assorted injections, while William W Potter (1880), Prof Kaltenbach and Toronto’s Dr Temple debated causes and care.

Momentum ebbed in the late 1950s–1960s when thalidomide, marketed as a safe anti-emetic, reshaped risk calculus and dulled prescribing confidence for pregnant patients; critics argue this overcorrection left many without effective treatment even when inaction caused harm.

Contemporary work led by geneticist Marlena Fejzo links HG to GDF15; studies associate HG with small-for-gestational-age infants and risks including abnormal brain growth, neurodevelopmental delay, vitamin K-deficient embryopathy, autism spectrum disorder, childhood cancer and respiratory disorders; in 2022, 26-year-old teacher Jessica Cronshaw died by suicide at 28 weeks and her baby died four days after C-section, while one study reports 4.9% terminated a wanted pregnancy and more than a quarter considered suicide.

Numbers in the account include 1,296 pages, 6am, 10 to 20 times a day, 3%, 11%, 2012, 13 weeks, 1880, the 1950s and 1960s, one to two days, 2022, 26 years, 28 weeks, four days, 4.9%, more than a quarter and greater than 70%, alongside type 2.

Method and source references span Victorian British Medical Journals, the American Journal of Obstetrics and Diseases of Women and Children, the Evening Standard, an inquest report and recent peer-reviewed studies and trials exploring pre-pregnancy GDF15-increasing regimens (metformin) and pregnancy-period GDF15-blocking drugs, with the June 2025 study reporting the metformin association.

31 July 2025 09:36 By London Health News Desk