Main Article Content
Abstract
Background: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy with significant maternal health implications. Helicobacter pylori (H. pylori), a gram-negative bacterium associated with gastric conditions, has been proposed as a contributing factor through gastric mucosal inflammation, hormonal interactions, and immune responses.
Aim: To assess the relationship between H. pylori infection and hyperemesis gravidarum.
Methods: A prospective case-control study was conducted at Bint al-Huda Hospital, Thi Qar City, from December 2023 to December 2024. Ninety-eight first-trimester pregnant women were enrolled: 50 with HG (cases) and 48 without HG (controls). Serum H. pylori IgG levels were measured using ELISA. Statistical analyses were performed using SPSS version 26 (p ≤ 0.05).
Results: Mean age was comparable between groups (29.08 ± 3.4 vs. 28.9 ± 2.8 years; p = 0.053). Most participants were housewives residing in rural areas, with no significant inter-group differences. H. pylori IgG seropositivity was significantly higher in HG cases than controls (72% vs. 29%; p < 0.001). Infected women demonstrated more severe clinical manifestations, including dehydration and electrolyte imbalances.
Conclusions: A significant association between H. pylori infection and hyperemesis gravidarum was identified, suggesting H. pylori may exacerbate gastrointestinal symptoms. Routine screening and eradication therapy may improve maternal outcomes. Further research exploring pathophysiological mechanisms is warranted
Keywords
Article Details
Copyright (c) 2026 Wasan Shareef Hameed, Nadia Saddam Fahad (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
- Jennings LK, Mahdy H. Hyperemesis gravidarum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
- Miernyk KM, Bulkow LR, Gold BD, Bruce MG, Reasonover AL, Morris JM, et al. Prevalence of Helicobacter pylori among Alaskans: factors associated with infection and comparison of urea breath test and anti-Helicobacter pylori IgG antibodies. Helicobacter. 2018;23(3):e12482. https://doi.org/10.1111/hel.12482
- Elmahdy M, Elmarsafawy A, Elkafash D. Association between Helicobacter pylori infection and hyperemesis gravidarum. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3175–3180. https://doi.org/10.18203/2320-1770.ijrcog20163007
- Bello AK, Umar AB, Borodo MM. Prevalence and risk factors for Helicobacter pylori infection in gastroduodenal diseases in Kano, Nigeria. Afr J Med Health Sci. 2018;17(1):41–46. https://doi.org/10.4103/ajmhs.ajmhs_12_18
- Isa MA, Onuegbu CU, Bulakarima AU, Hassan MN, Adam U, Garba MI, et al. Seroprevalence of Helicobacter pylori among pregnant women attending antenatal clinic in University of Maiduguri Teaching Hospital, Borno State, Nigeria. Bioglobia. 2015;2(2):18–23.
- Ali A, AlHussaini KI. Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies. Microorganisms. 2024;12(1):222. https://doi.org/10.3390/microorganisms12010222
- Kazemzadeh M, Kashanian M, Baha B, Sheikhansari N, Moradi Y. Evaluation of the relationship between Helicobacter pylori infection and hyperemesis gravidarum. Med J Islam Repub Iran. 2014;28:72.
- Cardaropoli S, Rolfo A, Todros T. Helicobacter pylori and pregnancy-related disorders. World J Gastroenterol. 2014;20(3):654–664. https://doi.org/10.3748/wjg.v20.i3.654
- Gupta A, Shetty S, Mutalik S, Bhatt P, Gurram AK, Yadav D. Treatment of Helicobacter pylori infection and gastric ulcer: need for novel pharmaceutical formulation. Heliyon. 2023;9(10):e20406. https://doi.org/10.1016/j.heliyon.2023.e20406
- Joshi A, Chadha G, Narayanan P. From discomfort to distress: a critical analysis of hyperemesis gravidarum in the emergency room. Cureus. 2023;15(8):e44004. https://doi.org/10.7759/cureus.44004
- Solomon D, Morka G, Wayessa ZJ. Determinants of hyperemesis gravidarum among pregnant women in public hospitals of Guji, West Guji, and Borana zones, Oromia, Ethiopia, 2022. SAGE Open Med. 2023;11:20503121231196713. https://doi.org/10.1177/20503121231196713
- Pont S, Bond DM, Shand AW, Khan I, Roberts CL. Risk factors and recurrence of hyperemesis gravidarum: a population-based record linkage cohort study. Acta Obstet Gynecol Scand. 2024;103(12):2392–2400. https://doi.org/10.1111/aogs.14871
- Mohammed Seid A, Mehari EA, Bekalu AF, Tiruneh AM, Amare AT. Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: multicenter cross-sectional study. SAGE Open Med. 2024;12:20503121241257163. https://doi.org/10.1177/20503121241257163
- Jennings LK, Mahdy H. Hyperemesis gravidarum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 https://www.ncbi.nlm.nih.gov/books/NBK532917/
- Popa SL, Barsan M, Caziuc A, Pop C, Dita MO, Popa LC, et al. Life-threatening complications of hyperemesis gravidarum. Exp Ther Med. 2021;21(6):642. https://doi.org/10.3892/etm.2021.10054
- Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011;40(2):309–334. https://doi.org/10.1016/j.gtc.2011.03.009
- Jenabi E, Salehi AM, Aghababaei S, Bashirian S. Pre-pregnancy body mass index and the risk of hyperemesis gravidarum: a systematic review and meta-analysis. Clin Exp Obstet Gynecol. 2024;51(4). https://doi.org/10.31083/j.ceog5104090
- Galletta MAK, Cavalcanti MHA, Barros MDS, Menezes-Filho JA. Weight loss among pregnant women hospitalized because of hyperemesis gravidarum: is there a lack of nutrition intervention? Nutr Clin Pract. 2022;37(4):887–895. https://doi.org/10.1002/ncp.10794
- 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;2015:278905. https://doi.org/10.1155/2015/278905
- Ng QX, Venkatanarayanan N, De Deyn MLZQ, Ho CYX, Mo Y, Yeo WS. A meta-analysis of the association between Helicobacter pylori infection and hyperemesis gravidarum. Helicobacter. 2018;23(1):e12455. https://doi.org/10.1111/hel.12455
- Hussein KS. Hyperemesis gravidarum in first-trimester pregnant Saudi women: is Helicobacter pylori a risk factor? Front Physiol. 2020;11:926. https://doi.org/10.3389/fphys.2020.00926
- Gaba N, Gaba S. Study of liver dysfunction in hyperemesis gravidarum. Cureus. 2020;12(6):e8709. https://doi.org/10.7759/cureus.8709
- Ahmed KT, Almashhrawi AA, Rahman RN, Hammoud GM, Ibdah JA. Liver diseases in pregnancy: diseases unique to pregnancy. World J Gastroenterol. 2013;19(43):7639–7646. https://doi.org/10.3748/wjg.v19.i43.7639-/
- Imaeda M, Tanaka S, Fujishiro H, Tsuda Y, Mimura M, Kato N. Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study. J Eat Disord. 2016;4:37. https://doi.org/10.1186/s40337-016-0123-6
- Aslan MM, Yeler MT, Biyik I, Aktas A, Ustun YE. Hematological parameters to predict the severity of hyperemesis gravidarum and ketonuria. Rev Bras Ginecol Obstet. 2022;44(5):458–466. https://doi.org/10.1055/s-0041-1741439
References
Jennings LK, Mahdy H. Hyperemesis gravidarum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
Miernyk KM, Bulkow LR, Gold BD, Bruce MG, Reasonover AL, Morris JM, et al. Prevalence of Helicobacter pylori among Alaskans: factors associated with infection and comparison of urea breath test and anti-Helicobacter pylori IgG antibodies. Helicobacter. 2018;23(3):e12482. https://doi.org/10.1111/hel.12482
Elmahdy M, Elmarsafawy A, Elkafash D. Association between Helicobacter pylori infection and hyperemesis gravidarum. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3175–3180. https://doi.org/10.18203/2320-1770.ijrcog20163007
Bello AK, Umar AB, Borodo MM. Prevalence and risk factors for Helicobacter pylori infection in gastroduodenal diseases in Kano, Nigeria. Afr J Med Health Sci. 2018;17(1):41–46. https://doi.org/10.4103/ajmhs.ajmhs_12_18
Isa MA, Onuegbu CU, Bulakarima AU, Hassan MN, Adam U, Garba MI, et al. Seroprevalence of Helicobacter pylori among pregnant women attending antenatal clinic in University of Maiduguri Teaching Hospital, Borno State, Nigeria. Bioglobia. 2015;2(2):18–23.
Ali A, AlHussaini KI. Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies. Microorganisms. 2024;12(1):222. https://doi.org/10.3390/microorganisms12010222
Kazemzadeh M, Kashanian M, Baha B, Sheikhansari N, Moradi Y. Evaluation of the relationship between Helicobacter pylori infection and hyperemesis gravidarum. Med J Islam Repub Iran. 2014;28:72.
Cardaropoli S, Rolfo A, Todros T. Helicobacter pylori and pregnancy-related disorders. World J Gastroenterol. 2014;20(3):654–664. https://doi.org/10.3748/wjg.v20.i3.654
Gupta A, Shetty S, Mutalik S, Bhatt P, Gurram AK, Yadav D. Treatment of Helicobacter pylori infection and gastric ulcer: need for novel pharmaceutical formulation. Heliyon. 2023;9(10):e20406. https://doi.org/10.1016/j.heliyon.2023.e20406
Joshi A, Chadha G, Narayanan P. From discomfort to distress: a critical analysis of hyperemesis gravidarum in the emergency room. Cureus. 2023;15(8):e44004. https://doi.org/10.7759/cureus.44004
Solomon D, Morka G, Wayessa ZJ. Determinants of hyperemesis gravidarum among pregnant women in public hospitals of Guji, West Guji, and Borana zones, Oromia, Ethiopia, 2022. SAGE Open Med. 2023;11:20503121231196713. https://doi.org/10.1177/20503121231196713
Pont S, Bond DM, Shand AW, Khan I, Roberts CL. Risk factors and recurrence of hyperemesis gravidarum: a population-based record linkage cohort study. Acta Obstet Gynecol Scand. 2024;103(12):2392–2400. https://doi.org/10.1111/aogs.14871
Mohammed Seid A, Mehari EA, Bekalu AF, Tiruneh AM, Amare AT. Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: multicenter cross-sectional study. SAGE Open Med. 2024;12:20503121241257163. https://doi.org/10.1177/20503121241257163
Jennings LK, Mahdy H. Hyperemesis gravidarum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 https://www.ncbi.nlm.nih.gov/books/NBK532917/
Popa SL, Barsan M, Caziuc A, Pop C, Dita MO, Popa LC, et al. Life-threatening complications of hyperemesis gravidarum. Exp Ther Med. 2021;21(6):642. https://doi.org/10.3892/etm.2021.10054
Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011;40(2):309–334. https://doi.org/10.1016/j.gtc.2011.03.009
Jenabi E, Salehi AM, Aghababaei S, Bashirian S. Pre-pregnancy body mass index and the risk of hyperemesis gravidarum: a systematic review and meta-analysis. Clin Exp Obstet Gynecol. 2024;51(4). https://doi.org/10.31083/j.ceog5104090
Galletta MAK, Cavalcanti MHA, Barros MDS, Menezes-Filho JA. Weight loss among pregnant women hospitalized because of hyperemesis gravidarum: is there a lack of nutrition intervention? Nutr Clin Pract. 2022;37(4):887–895. https://doi.org/10.1002/ncp.10794
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;2015:278905. https://doi.org/10.1155/2015/278905
Ng QX, Venkatanarayanan N, De Deyn MLZQ, Ho CYX, Mo Y, Yeo WS. A meta-analysis of the association between Helicobacter pylori infection and hyperemesis gravidarum. Helicobacter. 2018;23(1):e12455. https://doi.org/10.1111/hel.12455
Hussein KS. Hyperemesis gravidarum in first-trimester pregnant Saudi women: is Helicobacter pylori a risk factor? Front Physiol. 2020;11:926. https://doi.org/10.3389/fphys.2020.00926
Gaba N, Gaba S. Study of liver dysfunction in hyperemesis gravidarum. Cureus. 2020;12(6):e8709. https://doi.org/10.7759/cureus.8709
Ahmed KT, Almashhrawi AA, Rahman RN, Hammoud GM, Ibdah JA. Liver diseases in pregnancy: diseases unique to pregnancy. World J Gastroenterol. 2013;19(43):7639–7646. https://doi.org/10.3748/wjg.v19.i43.7639-/
Imaeda M, Tanaka S, Fujishiro H, Tsuda Y, Mimura M, Kato N. Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study. J Eat Disord. 2016;4:37. https://doi.org/10.1186/s40337-016-0123-6
Aslan MM, Yeler MT, Biyik I, Aktas A, Ustun YE. Hematological parameters to predict the severity of hyperemesis gravidarum and ketonuria. Rev Bras Ginecol Obstet. 2022;44(5):458–466. https://doi.org/10.1055/s-0041-1741439
