HELICOBACTER PYLORI INFECTION IN ANEMIC PREGNANCY IN BAGHDAD, IRAQ.

  • Ministry of Health - Baghdad Medical office - Al-Karkh, - Karkh Maternity Hospital, Baghdad, Iraq.
  • High Institute of Infertility Diagnosis and ART's, AL-Nahrain University, Baghdad, Iraq.
Crossref Cited-by Linking logo

  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Background: Helicobacter pylori infection is one of the most common and endemic human infections worldwide, causing a number of very common and important gastrointestinal problems such as peptic ulcer, iron deficiency anemia and chronic gastritis. In general infecting almost half of the people in developed countries and 80% of people in developing countries. Objective: to identify the association between H. pylori infection and iron deficiency anemia in pregnant women. Methods: A cross-sectional study done at Obstetrics and Gynecology Department of three hospitals in Baghdad city, during the period from the first of January to 30th of September 2017. The study included 400 anemic pregnant women selected randomly and all subjects were analyzed in full details and hemoglobin estimation done during the 1st visit, and h.pylori test. Result: study sample divided into (51.8%) as a mild anemia, (33.8%) as a moderate anemia and severe anemia as 58(14.5%). The rate of a positive test among pregnant women who?s had an infection by h. pyloriwere 63% which is higher than those women with the negative test as 37% with a significant association were found between h. pylori infection and iron deficiency anemia (p=0.001). Also The rate of positive h.pylori infected among pregnant women those were live in urban area was 37% which is higher than those living in rural 16% and the rate of pregnant women that have gastric discomfort more among those women with positive h.pylori infected were 35% but the women with negative h.pylori infected 30% .but without any significant association of residency and gastric discomfort with h.pylori infected. Conclusion:Helicobacter pylori (H. pylori) infection inpregnancy is more associated with iron deficiency anemia.

  1. Gautam, CS.; Saha, L.; Sekhri, K. &Saha, PK. (2008). Iron deficiency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape J. Med.10(12):283.
  2. World Health Organization, (1994).Prevention and Management of Severe Anemia in Pregnancy. Report of a technical working group. Geneva: WHL/FHE/MSM/93:3.
  3. Seck BC.?Supplementation strategy and its impact on hematological status in the control of anemia of pregnancy in Senegal?(Doctoral dissertation).
  4. Carlin A, Alfirevic Z. Physiological changes in pregnancy and monitoring. Best Practice & Research Clinical Obstetrics &Gynaecology. 2008 Oct 1;22(5):801-23.
  5. WHO (2004): Micronutrient deficiency: Battling iron deficiency anemia: the challenge.
Available from: http://www.who.int/nut/ida.htm, accessed on April 24, 2008.
  1. Mason, R Helwig (2005): ?Recent trends in malnutrition in developing regions: Vitamin A deficiencies, anemia, iodine deficiency, and child underweight?, Food and Nutrition Bulletin 26: 57-162.
  2. Gillespie CA, Woodgate RL, Chalmers KI, Watson WT. ?Living with risk?: mothering a child with food-induced anaphylaxis. Journal of Pediatric Nursing. 2007 Feb 1;22(1):30-42.
  3. Sabina S, Iftequar S, Zaheer Z, Khan MM, Khan S. An overview of anemia in pregnancy. JIBS2015; 2:144‑
  4. George-Gay B, Parker K. Understanding the complete blood count with differential. Journal of PeriAnesthesia Nursing. 2003 Apr 1;18(2):96-117.
  5. Bashiri A, Burstein E, Sheiner E, Mazor M. Anemia during pregnancy and treatment with intravenous iron: a review of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2003 Sep 10;110(1):2-7.
  6. Malaty HM. Epidemiology of Helicobacter pylori infection. Best Pract Res ClinGastroenterol 2007; 21: 205-214 [PMID: 17382273 DOI 10.1016/j.bpg.2006.10.005].
  7. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002; 347: 1175-1186 [PMID: 12374879 DOI: 10.1056/ NEJMra020542347/15/1175].
  8. Graham DY, Yamaoka Y. Disease-specific Helicobacter pylori virulence factors: the unfulfilled promise. Helicobacter 2000; 5 Suppl 1: S3-9; discussion S27-31 [PMID: 10828748].
  9. Harris PR, Mobley HL, Perez-Perez GI, Blaser MJ, Smith PD. Helicobacter pylori urease is a potent stimulus of mononuclear phagocyte activation and inflammatory cytokine production. Gastroenterology 1996; 111: 419-425 [PMID: 8690207 DOI: 10.1053/gast.1996.v111.pm8690207].
  10. Yamaoka Y, Kwon DH, Graham DY. AM(r) 34,000 proinflammatory outer membrane protein (oipA) of Helicobacter pylori. ProcNatlAcadSci USA 2000; 97: 7533-7538 [PMID: 10852959 DOI: 10.1073/pnas.130079797].
  11. Mahdavi J, Sond?n B, Hurtig M, Olfat FO, Forsberg L, Roche N, Angstrom J, Larsson T, Teneberg S, Karlsson KA, Altraja S, Wadstr?m T, Kersulyte D, Berg DE, Dubois A, Petersson C, Magnusson KE, Norberg T, Lindh F, Lundskog BB, Arnqvist A, Hammarstr?m L, Bor?n T. Helicobacter pylori SabAadhesin in persistent infection and chronic inflammation. Science 2002; 297: 573-578 [PMID: 12142529 DOI: 10.1126/science.1069076].
  12. Broussard CN, Richter JE. Nausea and vomiting of pregnancy. GastroenterolClin North Am 1998; 27: 123-151 [PMID: 9546087 DOI: 10.1016/S0889-8553(05)70350-2].
  13. Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11: 527-539 [PMID: 16006438 DOI: 10.1093/humupd/ dmi021]
  14. Golberg D, Szilagyi A, Graves L. Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review. ObstetGynecol 2007; 110: 695-703 [PMID: 17766620 DOI: 10.1097/01.AOG.0000278571.93861.26].
  15. Banić M, Franceschi F, Babić Z, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter 2012; 17 Suppl 1: 49-55.
  16. Chang J, Streitman D. Physiologic adaptations to pregnancy. NeurolClin 2012; 30: 781-789 [PMID: 22840789 DOI: 10.1016/j.ncl.2012.05.001]
  17. Hajishafiha M, Ghasemi-Rad M, Memari A, Naji S, Mladkova N, Saeedi V. Effect of Helicobacter pylori infection o pregnancy rates and early pregnancy loss after intracytoplasmicsperm Int J Womens Health 2011; 3: 329-335.
  18. Cardaropoli S, Piazzese A, Piccoli E, Rolfo A, Todros T. Is Helicobacter pylori infection a risk factor for miscarriage? Placenta 2013; 34: A37-A38 [DOI: 10.1016/j.placenta.2013.06.112]
  19. Kitagawa M, Natori M, Katoh M, Sugimoto K, Omi H, Akiyama Y, Sago H. Maternal transmission of Helicobacter pylori in the perinatal period. J ObstetGynaecol Res 2001; 27: 225-230 [PMID: 11721735 DOI: 10.1111/j.1447-0756.2001. tb01256.x]
  20. Eslick GD, Yan P, Xia HH, Murray H, Spurrett B, Talley NJ Foetal intrauterine growth restrictions with Helicobacter pylori infection. Aliment PharmacolTher 2002; 16: 1677-1682.
  21. Karger A, Ozkan O, Ozer S, Bayir B, Kilic S, Babur C, Danişman N. Gastrointestinal symptoms and Helicobacter pylori infection in early pregnancy. A seroepidemiologic study. GynecolObstet Invest 2008; 66: 44-46 .
  22. Cardaropoli S, Rodolfo A, Todros T. Helicobacter pylori and pregnancy-related disorders. World Journal of Gastroenterology: WJG. 2014 Jan 21;20(3):654.
  23. Palframan SL, Kwok T, Gabriel K. Vacuolatingcytotoxin A (VacA), a key toxin for Helicobacter pylori pathogenesis. Front Cell Infect Microbiol 2012; 2: 92.
  24. Cutler AF, Havstad S, Ma CK, Blaser MJ, Perez-Perez GI, Schubert TT. The accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection. Gastroenterology. 1995 Jul 1;109(1):136-41.
  25. Akcam M, Ozdem S, Yilmaz A, Gultekin M, Artan R. Serum ferritin, vitamin B (12), folate, and zinc levels in children infected with Helicobacter pylori. Dig Dis Sci 2007; 52: 405-410.
  26. Suzuki T, Matsushima M, Masui A, Watanabe K, Takagi A, Ogawa Y, Shirai T, Mine T. Effect of Helicobacter pylori eradication in patients with a chronic idiopathic thrombocytopenic purpura-a randomized controlled trial. Am J Gastroenterol 2005; 100: 1265-1270.
  27. Bazzoli F, Pozzato P, Rokkas T. Helicobacter pylori: the challenge in therapy. Helicobacter 2002; 7 Suppl 1: 43-49.
  28. Every AL. Key host-pathogen interactions for designing novel interventions against Helicobacter pylori. Trends Microbiol 2013; 21: 253-259.
  29. Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 2006; 163: 127-134 [PMID: 16306309 DOI:
  30. Brabin BJ, Hakimi M, Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutr 2001; 131: 604S-614S; discussion 614S-615S [PMID: 11160593]
  31. Muhsen K, Cohen D. Helicobacter pylori infection and anemia. Am J Trop Med Hyg 2013; 89: 398 [
  32. Dolatian M, Noori R, Zoology H, AlaviMajd H. The relationship between Helicobacter pylori infection and anemia in pregnant women. J ReprodFertil 2007; 8:238‑
  33. Ali MA, Muhammad EM, Hameed BH, Hasoobe HH. The impact of Helicobacter pylori infection on iron deficiency anemia in pregnancy. Iraqi Journal of Hematology. 2017 Jul 1;6(2):60.
  34. Saler T, Fakir ?zg?r K, Sibel K Jr., S?leyman A, G?layOrto L. H. pylori may not be associated with iron deficiency anemia in patients with the normal gastrointestinal tract. Advances in Hematology 2014; 2014:4.
  35. VanVliet AH, Ketley JM, Park SF, Penn CW. The role of iron in Campylobacter gene regulation, metabolism and oxidative stress defense. FEMS Microbiol Rev 2002;26:173‑86
  36. Mayim B, Celik NY, Yanık FF. Helicobacter pylori infection detected by 14C‐Urea breath test is associated with iron deficiency anemia in pregnant women. Journal of Obstetrics and Gynaecology Research. 2008 Dec 1;34(6):980-5.
  37. Broussard CN, Richter JE. Nausea and vomiting of pregnancy. GastroenterolClin North Am 1998; 27: 123-151 [PMID: 9546087 DOI: 10.1016/S0889-8553(05)70350-2]
  38. Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11: 527-539 [PMID: 16006438 DOI: 10.1093/humupd/ dmi021]
  39. Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum. A review. J Reprod Med 1994; 39: 605-612 [PMID: 7996524]
  40. Eliakim R, Abulafia O, Sherer DM. Hyperemesis gravidarum: a current review. Am J Perinatol2000; 17: 207-218 [PMID: 11041443 DOI: 10.1055/s-2000-9424]
  41. Guven MA, Ertas IE, Coskun A, Ciragil P. Serologic and stool antigen assay of Helicobacter pylori infection in hyperemesis gravidarum: which test is useful during early pregnancy? Taiwan J ObstetGynecol2011; 50: 37-41 [PMID: 21482373 DOI: 10.1016/j.tjog.2009.11.003]
  42. Golberg D, Szilagyi A, Graves L. Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review. ObstetGynecol2007; 110: 695-703.
  43. Karadeniz RS, Ozdegirmenci O, Altay MM, Solaroglu A, Dilbaz S, Hazel N, Haberal A. Helicobacter pylori seropositivity and stool antigen in patients with hyperemesis gravidarum. Infect Dis ObstetGynecol2006; 2006: 73073
  44. Shirin H, Sadan O, Shevah O, Bruck R, Boaz M, Moss SF, Everson S, Glezerman M, Avni Y. Positive serology for Helicobacter pylori and vomiting in the pregnancy. Arch GynecolObstet2004; 270: 10-14
  45. Berker B, Soylemez F, Cengiz SD, Kose SK. Serologic assay of Helicobacter pylori infection. Is it useful in hyperemesis gravidarum? J Reprod Med 2003; 48: 809-812
  46. Jacobson GF, Autry AM, Somer-Shely TL, Pieper KL, Kirby RS. Helicobacter pylori seropositivity and hyperemesis gravidarum. J Reprod Med 2003; 48: 578-582 [PMID: 12971136]
  47. Aytac S, T?rkay C, Kanbay M. Helicobacter pylori stool antigen assay in hyperemesis gravidarum: a risk factor for hyperemesis gravidarum or not? Dig Dis Sci2007; 52: 2840-2843

[Bushra A. Najum, Abbas A. J. A-Salihi and Hanaa Mohammed Moheyaldeen. (2018); HELICOBACTER PYLORI INFECTION IN ANEMIC PREGNANCY IN BAGHDAD, IRAQ. Int. J. of Adv. Res. 6 (Nov). 1130-1147] (ISSN 2320-5407). www.journalijar.com

Bushra A. Najum
Ministry of Health - Baghdad Medical office - Al-Karkh, - Karkh Maternity Hospital, Baghdad, Iraq.

DOI:

Article DOI: 10.21474/IJAR01/8102      
DOI URL: https://dx.doi.org/10.21474/IJAR01/8102

Download Full Paper

Download PDF No. of Downloads: 27 | No. of Views: 97