Department for Genes and Environment, Division for Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Eur J Obstet Gynecol Reprod Biol. 2013 Mar;167(1):41-6. doi: 10.1016/j.ejogrb.2012.11.007. Epub 2012 Dec 27.
To study associations between Helicobacter pylori exposure and severe hyperemesis gravidarum (HG) among immigrant women in Norway by exploring IgG seropositivity and H. pylori antigens in faeces. Additionally, we investigated whether cytotoxin-associated gene A product (CagA) and vacuolating cytotoxin A (VacA) seropositivity modulated this association.
An institution-based case-control study among immigrant women in Norway was performed at Ullevål and Akershus University Hospitals in September 2005-December 2007. Blood samples were used to explore IgG, CagA and VacA seropositivity, and faecal samples were used to explore the presence of antigens. Multiple logistic regressions were used to study associations between HG and H. pylori exposure.
The sample comprised 170 women: 62 cases and 108 controls. The observed proportion of IgG seropositive women did not differ between cases and controls. Neither IgG seropositivity nor CagA and VacA seropositivity were significantly associated with HG. For IgG positive and CagA and VacA negative women, the crude OR was 1.26 (95% CI: 0.57-2.82). For those being IgG positive and CagA and VacA positive, the crude OR was 0.82 (0.40-1.68). Adjustment for confounding factors, such as maternal age, body mass index and earlier HG, did not change the results. Additional adjustment for faecal antigens did not change the conclusions regarding these associations. Likewise, the crude OR for H. pylori antigens was not statistically significant. Adjustment for confounders and IgG seropositivity did not change this result.
This study did not find H. pylori exposure to be significantly associated with severe HG among immigrant women in Norway. This was regardless of whether H. pylori exposure was investigated by IgG seropositivity, CagA and VacA seropositivity or by the presence of H. pylori antigens in faeces. These results may indicate that the association between H. pylori and HG is weaker than previously expected, particularly in populations with high prevalence of H. pylori infection.
通过探索粪便中 IgG 血清阳性和幽门螺杆菌抗原，研究挪威移民妇女中幽门螺杆菌暴露与严重妊娠剧吐（HG）之间的关联。此外，我们还研究了细胞毒素相关基因 A 产物（CagA）和空泡细胞毒素 A（VacA）血清阳性是否调节了这种关联。
2005 年 9 月至 2007 年 12 月，在挪威乌勒瓦尔和阿克什胡斯大学医院进行了一项基于机构的病例对照研究。使用血液样本探索 IgG、CagA 和 VacA 血清阳性，使用粪便样本探索抗原的存在。多变量逻辑回归用于研究 HG 与幽门螺杆菌暴露之间的关联。
该样本包括 170 名女性：62 例病例和 108 例对照。病例和对照组的 IgG 血清阳性女性比例无差异。IgG 血清阳性或 CagA 和 VacA 血清阳性均与 HG 无显著关联。对于 IgG 阳性且 CagA 和 VacA 阴性的女性，粗 OR 为 1.26（95%CI：0.57-2.82）。对于 IgG 阳性且 CagA 和 VacA 阳性的女性，粗 OR 为 0.82（0.40-1.68）。调整母体年龄、体重指数和早期 HG 等混杂因素并未改变结果。进一步调整粪便抗原并未改变这些关联的结论。同样，幽门螺杆菌抗原的粗 OR 也无统计学意义。调整混杂因素和 IgG 血清阳性并未改变这一结果。
本研究未发现幽门螺杆菌暴露与挪威移民妇女的严重 HG 显著相关。这与是否通过 IgG 血清阳性、CagA 和 VacA 血清阳性或粪便中幽门螺杆菌抗原来研究幽门螺杆菌暴露无关。这些结果可能表明，幽门螺杆菌与 HG 之间的关联比之前预期的要弱，特别是在幽门螺杆菌感染流行率较高的人群中。
