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September 26, 2025Evolution Medicine and Public Health3 citationsOpen Access

Of scents and cytokines: how olfactory and food aversions relate to nausea and immunomodulation in early pregnancy

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DKDayoon KwonDFDaniel M. T. FesslerDKDelaney A. Knorr

Key Points

  • Increased pro-inflammatory cytokine levels are linked to odor aversions in early pregnancy, indicating immune responses.
  • Around 67% of participants reported nausea, while 64% experienced food or odor aversions, mainly to tobacco smoke and meat.
  • Multivariable regression revealed a moderate association between odor aversions and Th1 cytokine levels, supporting adaptive immune responses.
  • The findings suggest that changes in sensory experiences may protect fetal development by upregulating behavioral responses.

Abstract

Abstract During pregnancy, the maternal body undergoes extensive physiological adaptations to support embryonic growth, including whole-body remodeling, that may induce odor and food aversions, as well as nausea and vomiting. The biological mechanisms behind odor and food aversions, and nausea and vomiting in early pregnancy remain largely unexplored. Our study investigated associations between these changes and cytokine profiles during pregnancy. A cohort of pregnant Latina women in Southern California (n = 58) completed a structured questionnaire on pregnancy ‘morning sickness’-related symptoms and aversions. Maternal plasma cytokine levels were measured between 5 and 17 weeks’ gestation. 64% of participants experienced odor or food aversions, primarily to tobacco smoke and meat; 67% reported nausea, and 66% experienced vomiting. Multivariable linear regression models revealed that odor aversions were moderately associated with increased pro-inflammatory T-helper-cell type (Th) 1 (Th1) composite cytokine levels. Women who found tobacco smoke aversive exhibited a shift towards Th1 immune responses, indicated by a higher Th1:Th2 ratio. Food aversions also showed a positive association with Th1 cytokine levels. A borderline positive association was noted between nausea and vomiting and the Th1:Th2 ratio. These findings are consistent with the hypothesis that gestational changes in olfactory and gustatory experience, and nausea and vomiting reflect adaptive upregulation of behavioral prophylaxis in ways that could protect the fetus. If this elevated Th1:Th2 ratio and pro-inflammatory phenotype are part of the maternal and embryonic response to embryogenesis, the behavioral and biological markers that we explore may provide an accessible index of fetal development during early pregnancy.

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Cite This Study

Kwon et al. (2025) studied this question.

synapsesocial.com/papers/68d6c687b1249cec298b2b35https://doi.org/10.1093/emph/eoaf016
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