What is it about?

We explain the mortality and morbidity of gestational malnutrition resulting from severe hyperemesis gravidarum both as it affects both mother and fetus. We also review the metabolism of the vitamin thiamin (or B1) in the treatment of Wernicke's and potentially why in some cases it is ineffective.

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Why is it important?

Only 20% of cases of Wernicke's encephalopathy are discovered in living patients; the majority of cases are found at autosphy. Wernicke's encephalopathy is a specific form of malnutrition of the brain and nervous system and has an extremely high fatality rate. Wernicke's can happen to many types of patients--including women with hyperemesis gravidarum, eating disorders, homeless persons, refugees, prisoners on hunger strikes as well as those persons abusing alcohol..


Hyperemesis gravidarum or the severe nausea and vomiting of pregnancy is gestational malnutrition-- as it begins often in early pregnancy. Nutritional interventions can prevent devasting results which occur yet many providers are reluctant to intervene and continue to resort to an outdated theory that the "fetus is the perfect parasite able to obtain the nutrients it needs for development" from its mother. The question to ask: can a malnourished mother share nutrients? This is a moral and ethical issue. Nutritionists are able to assist those providers who need additional skills and knowledge in providing the requisite nourishment to ensure a successful outcome.

Miriam Erick

Read the Original

This page is a summary of: Gestational malnutrition, hyperemesis gravidarum, and Wernicke's encephalopathy: What is missing?, Nutrition in Clinical Practice, October 2022, Wiley,
DOI: 10.1002/ncp.10913.
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