Helicobacter pylori infection and Hyperemesis gravidarum. An institution-based case-control study.
BACKGROUND
The etiology of Hyperemesis gravidarum (HG) is unclear. To test the hypothesis of an association between Helicobacter pylori infection and HG, an institution-based case-control study was performed at Aker University Hospital (AUH) during 1994-1999.


METHODS
From the same source population, 244 incident cases of HG and 244 pregnant women free of the disease (controls) were consecutively identified.


RESULTS
H. pylori were noted in 105 cases and 58 control subjects. The presence of H. pylori increased the risk of HG more than two fold (OR = 2.42, 95% CI: 1.64-3.57, P < 0.001). This association was much stronger in Africans as compared to non-Africans (OR = 5.26, 95% CI: 1.04-26.57 vs. OR = 1.67, 95% CI: 1.07-2.61) after controlling for the confounding effect of maternal age. A gradient effect of exposure to H. pylori, determined by presence of specific IgG antibody in serum, and increased frequency of HG was present in Africans (test for linear trend P = 0.05) and non-Africans (test for linear trend P = 0.004).


CONCLUSIONS
These results indicate that H. pylori increase the risk of HG with a dose-response pattern and stronger in Africans.
Sandven
Irene
I
Centre of Clinical Research, Unit of Epidemiology and Biostatistics, Ullevål University Hospital, 0407, Oslo, Norway. sair@uus.no
Abdelnoor
Michael
M
Wethe
Marianne
M
Nesheim
Britt-Ingjerd
BI
Vikanes
Ase
A
Gjønnes
Halvard
H
Melby
Kjetil K
KK
D000293:Adolescent; D000328:Adult; D044383:Black People; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000453:epidemiology / Q000208:ethnology* / Q000382:microbiology*; D015994:Incidence; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence