Helicobacter pylori infection and hyperemesis gravidarum: a prospective pilot study in India

Akhila M. V., Padmasri R.


Background: About 80% of all pregnant women experience some form of nausea and vomiting during their pregnancy. Hyperemesis gravidarum, the commonest indication for admission to hospital in the first half of pregnancy affects approximately 0.3%-2.0% of pregnancies. Helicobacter pylori infection has been implicated in the cause of nausea and occasional vomiting in early pregnancy. The objectives of this study are to determine the proportion of H. pylori seropositivity among women with hyperemesis gravidarum (HG) and determine its relation with socio-economic status.

Methods: This was a prospective study conducted in a tertiary hospital in Bangalore among 60 pregnant women with HG for a period of 12 months. Venous blood samples were obtained and serum IgG for H. pylori was measured using enzyme-linked immunosorbant assay (ELISA). Details regarding socioeconomic status, recurrence of symptoms and severity were noted.

Results: The proportion of H. pylori seropositivity among pregnant women with hyperemesis in our study was 70%.There was a significant increase in severity and recurrence of vomiting among seropositive cases. Women belonging to rural areas had 1.17 times the risk of infection compared to women with urban area. We also found women belonging to the lower socioeconomic status had 0.52 times more risk to develop Helicobacter pylori infection.

Conclusions: This study suggests that H. pylori is an independent risk factor for vomiting in pregnancy. Effective treatment and eradication of H pylori infection may help reduce severity and recurrence of vomiting among positive cases thus reducing its adverse consequences.


Hyperemesis gravidarum, H. pylori, Pregnancy, Seropositivity, Socioeconomic status, Vomiting

Full Text:



Shaban MM, Kandil HO, Elshafei AH. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. Am J Med Sci. 2014;347(2):101.

McCarthy FP, ELutomski J, Greene RA. Hyperemesis gravidarum: current perspectives. Int J Women’s Heal. 2014;6:720.

Cunningham, Gary F. Williams Obstetrics. 24th edition. New York: McGraw-Hill Education; 2014: 1070-1072.

Nasr AA, Aboulfoutouh I, Nada A, Younan MA, Saed M, El-Khayat W. H. pylori infection and hyperemesis gravidarum. Evidence Based Women’s Health J. 2012;2:100-3.

Sharamif SAH, Mansour-Ghanaei F, Fallah SSMS. H. pylori seropositivity and hyperemesis gravidarum. Med Sci Monit. 2003;9(1):CR12-15.

Grooten IJ, Den Hollander WJ, Roseboom TJ, Kuipers EJ, Jaddoe VW, Gaillard R, et al. Helicobacter pylori infection: a predictor of vomiting severity in pregnancy and adverse birth outcome. Am J Obstet Gynecol. 2017;216:512.e1-9.

Hayakawa S, Nakajima N, Karasaki -Suzuki M, Yoshinaga H, Arakawa Y, Satoh K, et al. Frequent presence of Helicobacter pylori genome in the saliva of patients with hyperemesis gravidarum. Am J Perinatol. 2000;17:243-7.

Ozcimen EE, Uckuyu A, Ustuner I, Yanik FM, Kulaksizoglu S, Oktem M, et al. Helicobacter pylori positivity in patients with hyperemesis gravidarum. Gynecol Obstet Reprod Med. 2006;12:165-8.

Erdem A, Arslan M, Erdem M, Yildirim G, Himmetoglu O. Detection of Helicobacter pylori seropositivity in hyperemesis gravidarum and correlation with symptoms. Am J Perinatol. 2002;19:87-92.

Kazerooni T, Taallom M, Ghaderi AA. Helicobacter pylori seropositivity in patients with Hyperemesis gravidarum. Int J Gynaecol Obstet. 2002;79:217-20.

Bagis T, Gumurdulu Y, Kayaselcuk F, Yilmaz ES, Killicadag E, Tarim E. Endoscopy in Hyperemesis gravidarum and Helicobacter pylori infection. Int J Gynaecol Obstet. 2002;79:105-9.

Karaca C, Guler N, Yazar A, Camlica H, Demir K, Yildirim G. Is lower socioeconomic status a risk factor for Helicobacter pylori infection in pregnant women with hyperemesis gravidarum?. Turk J Gastroenterol. 2004;15:86-9.

Li L, Li L, Zhou X, Xiao S, Gu H, Zhang G. Helicobacter pylori infection is associated with an increased risk of hyperemesis gravidarum:a meta-analysis. Gastroenterol Res Pract. 2015;278905.

Niemeijer MN, Grooten IJ, Vos N. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211:150.e1-15.

Ng QX, Venkatanarayanan N, De Deyn MLZQ, Ho CYX, Mo Y, Yeo WS. A meta-analysis of the association between Helicobacter pylori (H. pylori) infection and hyperemesis gravidarum. 2018;23(1).

Shaban MM, Kandil HO, Elshafei AH. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. Am J Med Sci. 2014;347(2):101-5.

Sameh SS, Elmahdy M, Elmarsafawy A, Elkafash D, Azza E. Helicobacter pylori Infection in Cases of Hyperemesisgravidarum; Updates. J Gynecol Women's Health. 2017;4(4).

Smith S, Jolaiya T, Fowora M. Pia P, Favour N, Moses B, et al. Clinical and socio- demographic risk factors for acquisition of Helicobacter pylori infection in Nigeria. Asian Pac J Cancer Prev. 2018;19(7):1851-7.

Shirin H, Sadan O, Shevah O, Bruck R, Boaz M, Moss SF, et al. Positive serology for Helicobacter pylori and vomiting in the pregnancy. Arch Gynecol Obestet. 2004;270:10-4.