|Letters to Editor|
|H.pylori and CagA Infection of Pregnancy Women and Hyperemesis Gravidarum|
|Rozita Hosseinzadeh Fasaghandis1, Fatemeh Abbasalizadeh1, Asghar Rajabzadeh2|
|1Women’s Reproductive Health Research Center, Tabriz university of Medical sciences, Tabriz, Iran
2Department of Anatomical Sciences, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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This letter claims that H.pylori infection may be effective on excessing hyperemesis gravidarum in pregnant women. Ordinary, there are different methods to H.pylori detection in the scientific laboratory, but many of false reports result in critical conditions like ulcer and carcinoma. Gastric complications including vomiting and nausea are a sever forms of pregnancy-associated sickness among 45 to 95 percent of women (1). Hyperemesis gravidarum (HG) is the main causes of gastric malformation and mucosa associated-lymphoma with weight losing, metabolic disturbance and nutritional problems (2-5). There are also factors involvingHG, like steroids hormones (estradiol and progesterone) and immunological disorders (6). H.pylori (Helicobacter pylori) is the major factor of gastro-duodenal diseases with high mortality rate (7). H.pylori infection had a strong correlation with highly risk of HG (2). Although there were studies on relationship between HG and H.pylori infection, some research did not quite belief on it.Then, it seems to be need more works concerning HG and H.pylori infection and other relating factors.
At the our previous study, the results obtained from H.pylori serum antibody test showed that 36 cases of HG and 34 of control were positive to H.pylori infection (81.8%, 77.2% respectively). Infected with CagA (Cytotoxin-associated gene A) through experimental and control was 45.4% and 27.2% respectively (6). Pregnant women positive to HG were in 6- 14 weeks of gestation. The average of Ig G titers shows not remarkably different between two groups.The levels of Ig G are ranged between 15 to 20 Au/ml for 2-4 weeks.
At serological method, to determining HG, three markers were considered including: vomiting, weight loss (more than 3 kg) and presence of positive ketonuria (8). In addition, some causes such as hyperthyroidism, multiple gestation, psychological and gastrointestinal disorders could be defined for vomiting (9).
It is suggested that testing methods to evaluate of H.pylori infection should be done by serological and nonserological. One of the non-serological testing is Hp PCR DNA which seems much more efficient forH.pylori detection.HpSA test is another way to proper obtaining of correlation between H.pylori and HG.
By regards to previous studies,Hyperemesis gravidarum could be impressed with differ inducers.Socio-economic status is the most factor for presenting H.pylori infection. It is appears that H.pylori might be one of the inducer of HG. We found not significantly different among groups similar to some studies (10, 11), although ones implied that HG patients have a greater rate of H.pylori infection. On the other hand, CagA gene could be increased pathogenicity of H.pylori strains (6).
Nausea and vomiting may be affected by multiple factors which infection by H.pylori be one of them.Therefore this study suggests that for confirming relation among H.pylori and HG, genetically, histologically and ELIZA testes must be done.
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