Frequent Presence of Helicobacter Pylori Genome in the Saliva of Patients With Hyperemesis Gravidarum

Abstract

Recently, possible involvement of Helicobacter pylori (H. pylori) in hyperemesis gravidarum have been reported based on serological studies and the therapeutic effects of antibiotics. In this study, we examined for the presence of H. pylori genome [by (PCR) of saliva] in combination with serological techniques. Thirty-four patients with hyperemesis and 29 normal pregnant subjects were examined for serum anti-H. pylori IgG antibodies and PCR of saliva. By serum antibody test, 16 of 34 hyperemesis patients (47.5%) were positive for anti-H. pylori IgG antibody, while 6 of 29 control subjects (20.6%) were positive (chi2 p < 0.0005). PCR revealed positive H. pylori genome in 21 cases out of 34 hyperemesis (61.8%, 14 of 16 patients positive for H. pylori antibody and 7 of H. pylori-antibody-negative 18 patients) and 8 of 29 control subjects (27.6%) (chi2 p < 0.000001). We suggest chronic infection of H. pylori as one of the important factors on the pathogenesis of hyperemesis gravidarum even though it may not be the single cause of the disorder.

Managing hyperemesis gravidarum: a multimodal challenge

“…In a metaanalysis of 14 case-control studies, which included a total of 1732 patients and controls, an association between the presence of helicobacter pylori and HG was suggested, although not all of the analysed studies reached statistical significance [odds ratio from 0.55 to 109.33, confidence interval (CI) 95%] [6]. Nevertheless, in one study examining both saliva (61.8% detection of helicobacter pylori in patients with HG versus 27.6% in symptom-free pregnant women) and serum (52.9% versus 20.7%) for the bacterium results were significant ( P < 0.0001, CI 95%) [17], as were cytotoxin-associated gene A and serum findings in a Chinese study [19]. Two observational studies of five patients with HG reported no improvement in symptoms in response to standard drug treatment.…”

Hyperemesis Gravidarum and Fetal Outcome

“…9 A recent promising focus is on suppression of HG by successful eradication of Helicobacter pylori. 10,11 A recent review by Philip 12 discusses other suggested causes of HG.…”

Helicobacter pylori infection and Hyperemesis gravidarum. An institution-based case–control study

“…Effect estimates of the association between H. pylori and HG from previous case-control studies on different populations in different geographic areas, varies a lot in magnitude showing very strong positive associations to none. In 1998, Frigo et al [8] first linked HG to H. pylori reporting a significant difference in H. pylori in patients with HG versus pregnant women without HG, and so did other authors the following years [9][10][11][12][13][14][15][16]18]. In 2003, Jacobson et al [22] first reported no association between H. pylori and HG, followed by others [17,[23][24][25][26].…”

“…The last decade, H. pylori has been a candidate etiologic factor for HG [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Many of the previous studies have been limited to relatively small sample size reporting only crude effect estimates.…”