Impact of maternal hyperemesis gravidarum on long-term health outcomes in children: A systematic review and meta-analysis

Background: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy with potential adverse effects on fetal development. Although short-term outcomes are relatively well-documented, long-term health consequences in offspring remain poorly understood.
Objective: To systematically review and quantitatively synthesize evidence on the long-term health outcomes of children born to mothers with HG.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Embase, Scopus, and Cochrane Library were searched up to March 2025. Studies reporting any long-term physical, cognitive, metabolic, or neurodevelopmental outcomes in offspring of HG pregnancies were included. Data were pooled using random-effects models, and heterogeneity was assessed using the I² statistic.
Results: Eleven studies comprising 1,024,385 participants met inclusion criteria. Meta-analysis showed that HG was significantly associated with increased risk of neurodevelopmental disorders (OR 1.35, 95% CI 1.11–1.63), attention-deficit/hyperactivity disorder (OR 1.24, 95% CI 1.09–1.42), and autism spectrum disorders (OR 1.44, 95% CI 1.20–1.72). No significant associations were found with metabolic or growth-related outcomes.
Conclusions: Offspring of mothers with HG are at increased risk of neurodevelopmental impairments. Clinicians should be aware of these risks and consider long-term developmental follow-up for affected children.