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Open Access Research article

Pharmacogenetic predictors of nausea and vomiting of pregnancy severity and response to antiemetic therapy: a pilot study

Amalia S Lehmann1, Jamie L Renbarger12, Catherine L McCormick3, Ariel R Topletz1, Carrie Rouse3 and David M Haas13*

Author Affiliations

1 Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA

2 Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

3 Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA

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BMC Pregnancy and Childbirth 2013, 13:132  doi:10.1186/1471-2393-13-132

Published: 20 June 2013

Abstract

Background

Nausea and vomiting of pregnancy (NVP) is a common condition. The objective of this study was to evaluate the association between response to antiemetics in the treatment of NVP and genetic polymorphisms in the serotonin receptor subunit genes HTR3A and HTR3B.

Methods

Pregnant women ≥18 years of age with NVP starting antiemetic therapy with promethazine, prochlorperazine, metoclopramide, or ondansetron at ≤ 16 weeks gestational age were eligible. The study recruited 29 women with complete data and sampling who returned for their one week follow-up and were genotyped for HTR3A and HTR3B polymorphisms. Severity of NVP was captured (using Pregnancy Unique Quantification of Emesis (PUQE) and Quality of Life (QOL) tools) upon enrollment and after one week of antiemetic therapy. These measures were correlated with pharmacogenetic variability.

Results

Subjects with genotype associated with high serotonin affinity of the 5-HT3B receptor (rs1176744, CC) required more antiemetic medications (p < 0.001) than other subjects. Those with genotypes associated with increased expression of the 5-HT3A receptor subunit (rs1062613, CT or TT) had worse final PUQE scores (p = 0.01) than other subjects while rs3782025 variants carriers had significantly better initial (p = 0.02) and final (p = 0.02) PUQE scores than other subjects.

Conclusions

HTR3B and HTR3A gene variants may contribute to variability in response to antiemetic therapy for NVP.

Keywords:
Pregnancy; Nausea and vomiting of pregnancy; Antiemetics; Pharmacogenomics