Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 4

Category: Physiology/Endocrinology

Poster Session 4

(1065) Glucocorticoid treatment associated with significantly lower hyperemesis gravidarum symptoms and emetogenic hormone (GDF15) levels

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Coauthor(s)

ZN

Zainab H. Neemuchwala

University of Southern California
University of Southern California/Los Angeles, California, United States
AH

Andrew Housholder, MD

The Morning Sickness Clinic
The Morning Sickness Clinic, Alabama, United States

Submitting Author and Presenting Author(s)

Dr. Marlena Fejzo, N/A

Researcher
University of Southern California
Los Angeles, California, United States

Objective:
Hyperemesis Gravidarum (HG), severe nausea and vomiting of pregnancy, is associated with adverse outcomes for mother and baby and can be life-threatening. Recently, a strong genetic link between HG and the emetogenic hormone GDF15 was discovered. Methylprednisolone has been associated with a reduction of GDF15 in an animal model. Glucocorticoids are used to treat HG when traditional antiemetics fail, and while fetal safety prior to 10 weeks’ gestation may be a concern due to potential association with oral clefts, they can be more effective in reducing symptoms and hospitalization. The mechanism of antiemetic action of glucocorticoids is unknown. We hypothesized that they may work by reducing GDF15 levels.

Study Design:
We analyzed circulating GDF15 levels (measured by ELISA-based assay) and HG symptoms (measured by validated HELP scoring tool) before and during treatment in 11 GA matched treatment-resistant HG patients treated with glucocorticoids (cases) and 11 HG patients treated with other antiemetics (controls) at The Morning Sickness Clinic. A standard t-test was used to compare means.

Results:
Cases and controls had similar (P >0.05) levels of GDF15 and HELP scores prior to treatment at ~12 weeks’ gestation. At ~14 weeks’ GDF15 levels had decreased in 9/11 cases and 4/11 controls. Cases had significantly greater reduction in GDF15 level (-1.1 ng/ml vs. +1.4 ng/ml, P</em>=0.03) and HELP scores (-19 vs. -11, P=0.03) compared to controls.

Conclusion:
Use of glucocorticoids in HG pregnancies is associated with a significant reduction in GDF15 levels and improved symptoms compared to traditional antiemetics. Since glucocorticoid use may be associated with risk, medications designed specifically to reduce GDF15 signaling may be favorable. Inhibitors of the GDF15 pathway reduce nausea and vomiting in animal models and are currently in clinical trials for cachexia and HG. This study is the first to show a correlation in reduction in GDF15 and medication effectiveness in reducing HG symptoms, providing clinical evidence to support development of GDF15-based therapeutics for HG.