Detection of Helicobacter pylori Seropositivity in Hyperemesis Gravidarum and Correlation with Symptoms

ABSTRACT

The aim of this study was to investigate whether there was a relationship between H. pylori (Helicobacter pylori) infection positivity and characteristics (time and duration) of hyperemesis gravidarum (HG) symptoms. Forty-seven pregnant women with HG and 39 pregnant controls at the same gestational weeks without any gastrointestinal symptoms were included in this prospective study. H. pylori serum Immunoglobulin (Ig) G concentrations were determined by enzyme-linked immunoadsorbent assay (ELISA) in patients with HG and controls. Positive serology for H. pylori was correlated with the duration of symptoms in patients with HG. The prevalence of H. pylori infection was 85.1% (40 of 47) and 64.1% (25 of 39) in patients with HG and controls, respectively (p <0.05, χ ² test). Mean values of H. pylori IgG (± standard deviation) were significantly higher in patients with HG than in controls (22.66 aIU/mL ± 22.34 vs. 11.54 aIU/mL ± 13.89, p <0.01, Student's t-test). In HG group, time (gestational weeks) and the duration (weeks) of HG symptoms for patients serologically positive and negative for H. pylori were 6.95 ± 1.55 versus 6.58 ± 1.78 weeks, (p >0.05, Student's t-test) and 8.35 ± 5.28 versus 11.40 ± 7.17 weeks (p >0.05, Mann-Whitney U-test), respectively. There was no correlation between duration of HG symptoms and serum H. pylori IgG concentrations. Although a majority of pregnant women with HG were serologically positive for H. pylori infection, there was no correlation between positive serology and duration of symptoms, which is not suggestive of a direct causal relationship between H. pylori infection and HG.

KEYWORD

Hyperemesis gravidarum - Helicobacter pylori, pregnancy

REFERENCES

• 1 Broussard C N, Richter J E. Nausea and vomiting of pregnancy.  Gastroenterol Clin North Am . 1998;  27 123-151
• 2 Depue R H, Bernstein L, Ross R K, Judd H L, Henderson B E. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: aseroepidemiologic study.  Am J Obstet Gynecol . 1987;  156 1137-1141
• 3 Leylek A, Çetin A, Toyaksi M. Hyperthyroidism in hyperemesis gravidarum.  Int J Gynecol Obstet . 1996;  55 34-37
• 4 Frigo P, Lang C, Reisenberger K, Kölbl H, Hirchl A M. Hyperemesis gravidarum associated with Helicobacter pylori seropositivity.  Obstet Gynecol . 1998;  91 615-617
• 5 El Younis M C, Abulafia O, Sherer D M. Rapid marked response of severe hyperemesis gravidarum to oral erythromycin.  Am J Perinatol . 1998;  15 533-534
• 6 Jacoby E B, Porter K B. Helicobacter pylori infection and persistent hyperemesis gravidarum.  Am J Perinatol . 1999;  16 85-88
• 7 Koçak I, Akcan Y, Üstün C, Demirel C, Cengiz L, Yanik F F. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum.  Int J Gynecol Obstet . 1999;  66 251-254
• 8 Hawtin P R. Serology and urea breath test in the diagnosis of H pylori infection.  Mol Biotechnol . 1999;  11 85-92
• 9 Oderda G, Vaira D, Holton J, Dowsett J F, Ansaldi N. Serum pepsinogen I and IgG antibody to Campylobacter pylori in non-specific abdominal pain in childhood.  Gut . 1989;  30 912-916
• 10 von Wulffen H, Grote H J. Enzyme-linked immunosorbent assay for detection of immunoglobulin A and G antibodies to Campylobacter pylori.  Eur J Clin Microbiol Infect Dis . 1988;  7 559-565
• 11 Rauws E AJ, Tytgat G NJ. Cure of duodenal ulcer associated with eradication of Helicobacter pylori.  Lancet . 1990;  335 1233-1235
• 12 Sipponen P, Varis K, Fraki O, Korri U M, Seppala K, Siurala M. Cumulative 10 year risk of symptomatic duodenal and gastric ulcer in patients with or without gastritis.  Scand J Gastroenterol . 1990;  25 966-973
• 13 Hayakawa S, Nakajima N, Karasaki-Suzuki M, Yoshinaga H, Arakawa Y, Satoh K, Yamamoto T. Frequent presence of Helicobacter pylori genome in the saliva of patients with hyperemesis gravidarum.  Am J Perinatol . 2000;  17 243-247
• 14 Sandıkçı M U, Doran F, Köksal F, Sandıkçı S, Uluhan R, Varınlı S, Akan E. Helicobacter pylori prevalence in a routine upper gastrointestinal endoscopy population.  Br J Clin Pract . 1993;  47 187-189
• 15 Al-Moagel M A, Evans D G, Abdulghani M E, Adam E, Evans D J, Malaty H M, Graham D Y. Prevalence of Helicobacter (formerly Campylobacter) pylori infection in Saadui Arabia, and comparison of those with and without upper gastrointestinal symptoms.  Am J Gastroenterol . 1990;  85 944-948
• 16 Mégraud F, Brassens Rabbé P M, Denis F, Belbouri A, Hoa D Q. Seroepidemiology of campylobacter pylori infection in various populations.  J Clin Mirobiol . 1989;  27 1870-1873
• 17 Sack R B, Gyr K. Helicobacter pylori infection in developing world.  Lancet . 1993;  341 1274-1275
• 18 Blecker U, Lanciers S, Hauser B. Validation of a new serologic test for the detection of Helicobacter pylori.  Acta Gastroenterol Belg . 1993;  56 309-314
• 19 Glupczynski Y, Brutte A. Failure of azythromycin to eradicate Campylobacter pylori from the stomach because of acquired resistance during treatment.  Am J Gastroenterol . 1990;  85 98-99
• 20 Hardy D J, Hanson C W, Hensey D M, Beyer J M, Fernandes P B. Susceptibility of Campylobacter pylori to macrolides and fluoroquinolones.  J Antimicrob Chemother . 1988;  22 631-636
• 21 McNulty C A, Gearty J C, Crump B, Davis M, Donovan I A, Melilian V, Lister D M, Wise R. Campylobacter pyloridis and associates gastritis: investigator blind, placebo controlled trial of bismuth salicylate and erythromycin ethylsuccinate.  Br Med J . 1986;  293 645-649