Hyperemesis Gravidarum in First-Trimester Pregnant Saudi Women: Is Helicobacter pylori a Risk Factor?

Khulood S Hussein

doi:10.3389/fphys.2020.00575

Abstract

IntroductionHyperemesis gravidarum (HG) is a serious complication of pregnancy involving nausea and vomiting which affects all facets of the lives of many women. Helicobacter pylori infection has been linked to HG in some regions of the world. However, the prevalence of H. pylori in Saudi Arabian pregnant women and its link to HG has not been the subject of previous research. Detecting and treating H. pylori infection in women early in their pregnancies may lower the likelihood of adverse maternal outcomes. This study aims to assess the connection between the pathogenesis of HG and H. pylori infection in this population.MethodsForty-five pregnant women with HG were recruited from the outpatient clinic for antenatal care in the Gynecology and Obstetrics Department at King Abdulaziz University Hospital. Forty-five pregnant women without HG were matched as controls. Both groups underwent testing for the H. pylori antigen in stool samples.ResultsA statistically significant difference (P < 0.05) was observed between the cases and controls in terms of the occurrence of H. pylori. Thirty-eight women in the HG group (84.4%) tested positive for H. pylori, while the same was true of only 20 of the controls (44.4%). The mean level of blood hemoglobin in positive cases was significantly lower than that in negative cases (9.56 ± 1.29 vs. 11.90 ± 1.18 g/dl, P = 0.012).ConclusionH. pylori may play a contributing role in the presence of HG in the study population. It may be included with other investigations of HG, especially with cases that do not respond to conventional management and continue into the second trimester. Women with H. pylori were also more likely to suffer from anemia compared to those without the infection. For this reason, those working with pregnant women should pay close attention to those infected with H. pylori. Additional large case–control studies are necessary to better understand the part H. pylori plays and the pathogenesis of HG.

Highlights

Hyperemesis gravidarum (HG) is a serious complication of pregnancy involving nausea and vomiting which affects all facets of the lives of many women
These contradictory findings likely stem from the lack of a universally accepted definition of HG, suggesting a wide variation in the study population. In their case–control study of 80 subjects (40 in each group), Guven et al (2011) found that the mean maternal age of women with HG and H. pylori stool antigen (HpSA) positivity and women in the control group to be significantly different (25.8 vs. 28.4 years, respectively, P = 0.025). This suggests that age is a noteworthy risk factor for H. pylori infection in women who have HG, our results suggest something different
Considering the elevated rate of H. pylori infection in the general population and some evidence indicating a correlation between H. pylori infection and some degree of liver damage, we evaluated whether H. pylori has any effects on the level of liver enzymes in the pregnant women studied

Summary

Introduction

Hyperemesis gravidarum (HG) is a serious complication of pregnancy involving nausea and vomiting which affects all facets of the lives of many women. Hyperemesis gravidarum (HG), a disorder characterized by ongoing severe nausea and vomiting with resulting ketosis, affects 0.3–2% of women during pregnancy (McCarthy et al, 2014). Those affected lose over 5% of their prepregnancy weight. If the condition is not properly managed, it can result in considerable health problems, including imbalances in electrolytes, malnourishment, Wernicke’s encephalopathy, clotting, depressive disorders, and adverse gestational outcomes such as prematurity, undersized fetuses, impaired development, and fetal anomalies (Dodds et al, 2006)

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