This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hyperemesis gravidarum (HG) is the severe form of the nausea and vomiting of pregnancy. It affects only 1-3% of pregnant women, but it is the second leading reason for pregnant women being admitted to the hospital. HG can affect both maternal and fetal health. It also causes suffering, loss of quality of life, and inability to fulfill family and work roles. The cause of HG is unknown, though early research found that women with strong emotional stress reactions, especially stress responses related to prior traumatic events, were more likely to have HG. The purpose of this research is to test the hypothesis that traumatic life events and posttraumatic stress reactions play a role in developing HG for some women. An additional hypothesis is that stress system hormone levels may be different in women experiencing posttraumatic stress, and these dysregulated hormones may be causing the digestive track to also become dysregulated, leading to severe nausea and vomiting. In order to test these hypotheses, women with HG will be compared with pregnant women who are experiencing mild, moderate, and no nausea and vomiting. During an 8-hour out-patient hospital stay participants will do several things: (1) answer questions in a survey interview about whatever level of past and present stressful and traumatic life events they have had, as well as about their levels of mood and stress symptoms; (2) allow placement of a small intravenous (IV) catheter so that blood samples can be collected to test levels of the hormones cortisol and oxytocin every 10 minutes over a period of one and a half hours; (3) initial blood work to verify pregnancy hormone levels; (4) have an electrogastrogram, a test that measures stomach electrical activity by wires placed on the skin; (5) heart and respiratory rate monitoring with LifeShirt system; and (6) take-home mail-in saliva sampling kit, which will provide additional cortisol hormone data so that we can see a full 24 hours worth of such data. Women with HG who come to the UM Hospitals for treatment will be invited to participate, and comparison women 8-16 weeks pregnant, whose symptoms are not severe enough to need hospital care, or who have no symptoms, will be sought via the community and prenatal services agencies and clinics. We are also recruiting women with hyperemesis from Hurley hospital in Flint and Foote hospital in Jackson (Having obtained IRB approval from all three hospital IRB's to do so). African American participants are especially sought because new research shows that they may have greater risk for HG. Currently, because the cause of HG is not known, treatment tries to decrease nausea and provide fluids and nutrition. The long-term goal of this research is to learn if treatments for posttraumatic stress that are safe for pregnant women would be better at stopping the nausea and vomiting.'