Helicobacter pylori infection and hyperemesis gravidarum: possible causal relationship with evaluation of a new immunoassay in stool compared with standard diagnostic techniques

ABSTRACT

The aim of the present study was to investigate any possible association between infection with Helicobacter pylori [H. pylori] and hyperemesis gravidarum [HG]. Moreover; evaluation of different methods used in the diagnosis of H. pylori during pregnancy aiming to present a simple non-invasive and reliable method. 68 pregnant women with hyperemesis gravidarum and 72 control pregnant women were enrolled in the study. All participants were examined both for H. pylori serum immunoglobulin G antibodies [HpIgG Ab], showing chronic infection, and H. pylori stool antigens [HpSA], and showing active gastrointestinal colonization. Serologically positive H. pylori infection was detected in 59 [86.8%] subjects of the hyperemesis gravidarum group and in 32 [44.4%] of the controls [P<0.01]. HpSA was detected in 45.6% of patients with hyperemesis gravidarum, whereas only 5.6% of patients in the control group were positive for this specific antigen [P<0.001]. The new stool immunoassay test had a sensitivity of 96% [95% confidence interval 90.6% to 100%], specificity of 93% [85.1% to 99.5%], positive predictive value of 92%, and negative predictive value of 96%. In conclusion, this study supports the studies suggesting an association between H. pylori and HG. Infection with H. pylori should be kept in mind in cases of HG in pregnant women. The findings of the current study have, also, demonstrated that HpSA as a relatively simple, inexpensive and time saving noninvasive test is a reliable method for detection of active H. pylori infections in pregnant women with hyperemesis gravidarum. This stool immunoassay represents a new, accurate, and non-invasive method for H pylori infection that overcomes the limitations of existing tests