Comparative Study between Patients with Hyperemesis Gravidarum and Normal Pregnancy Regarding Presence of Helicobacter Pylori Antibodies

Abstract
Background: The severe form of nausea and vomiting of pregnancy called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Helicobacter pylori (H. pylori) is a prevalent gram-negative flagellated spiral bacterium that colonizes the stomach of half of the world’s population. Researchers have hypothesized that maternal hormonal and immunological changes during pregnancy that prevent allogenic rejection of fetus reactivates the bacterium. Aim of the work is to compare between patients with hyperemesis gravidarum and normal pregnancy regarding presence of Helicobacter pylori antibodies for proper management. Materials and Methods: A case-control study was carried out on ninety pregnant women at 5-15 weeks of gestation, thirty pregnant females with single living fetus complaining of HG (Group A), Thirty pregnant females who were multiple pregnancy and/or trophoblastic disorders complaining of HG (Group B) and Thirty pregnant females with normal pregnancy (Group C). Serum test for H. pylori IgG antibody titer was done for all patients and controls using enzyme immunoassay-based kit. Results: H. pylori were noted in 32 hyperemetic cases and 6 control subjects. The presence of H. pylori increased the risk of HG more than two fold (OR = 2.923, 95% CI: 1.326-6.446, P < 0.05). Conclusion: There is powerful correlation between H. pylori and hyperemesis gravidarum which proved in single, multiple pregnancy and/or trophoblastic disorders.