Association between Helicobacter pylori Infection and Occurrence of Anemia among Pregnant Women Attending Antenatal Care in Kulito Health Center, Halaba Zone, South Ethiopia, 2018

Helicobacter pylori infection in pregnant women: Gastrointestinal symptoms and pregnancy- related disorders

Helicobacter pylori (H. Pylori) is a gram-negative, flagellated and spiral-shaped bacterial pathogen that impacts approximately 46% among pregnant women globally and has been associated with various maternal-fetal complications. Iron deficiency anemia, fetal growth restriction, cardiovascular diseases, and insufficient nutrient absorption can be observed in pregnant women, as well as miscarriages and pregnancy-specific hypertensive disease, such as pre-eclampsia. Thus, the evidence supports the influence of H. pylori infection on fetal implantation/placentation failure, and positive strains of the cytotoxin-associated gene A of H. Pylori were reported as the most prevalent in these conditions. However, current knowledge indicates a relationship between this infection and the occurrence of hyperemesis gravidarum, characterized by frequent nausea and vomiting. Regarding the diagnosis of this bacterial infection, non-invasive approaches such as stool antigen test, urea breath test, and serological tests are more accepted during pregnancy, as they are easy to carry out and cost-effective. Finally, the bacteria eradication therapy should consider the risks and benefits for the pregnant woman and her child, with pharmacological intervention depending on the clinical presentation.

Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis

Background

Anemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial.

Methods

PubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers.

Results

A total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference < 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy.

Conclusions

Prevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.

Magnitude of H. pylori and Its Association with Preeclampsia Among Pregnant Women in Ethiopia: A Case Control Study

Background

Helicobacter pylori infections are associated with many complications of pregnancy including preeclampsia. It has been suggested that H. pylori infection could contribute to the etiopathogenesis of preeclampsia by inducing a pro-inflammatory state.

Objective

To assess the magnitude of H. pylori infection and its association with preeclamptic and non-preeclamptic pregnant women attending antenatal care in Ethiopia.

Methods

Hospital-based case control study was conducted among clinically diagnosed preeclamptic and non-preeclamptic pregnant women. Stool samples were collected for H. pylori antigen test from study participants. The collected data were analyzed using statistical methods in SPSS version 23. Simple descriptive statistics were used to present the socio-demographic and clinical characteristics of the study subjects. Association between clinical variables, preeclampsia and H. pylori infection was performed with multivariate logistic regression. A p-value of <0.05 at 95% confidence level was considered as statistically significant in all the analyses.

Results

A total of 93 cases and 186 controls were included in this study. The overall prevalence of H. pylori infection in all study participants was 38.9% (16/272). The prevalence of H. pylori infection was higher in cases than controls, 54.3% (50/92) vs 31.1% (56/180), respectively. The mean age was 29.01 (SD±4.93) years in cases and 30.37 (SD± 6.2) years in control group. A positive association was found between H. pylori infection and preeclampsia (OR: 2.45; 95% CI: 2.41–4.10).

Conclusion

H. pylori infection has been found to be associated with preeclamptic pregnant women. In this study, the prevalence of H. pylori infection was higher in cases than in controls. Age group, educational status, occupational status and body mass index were significantly associated with preeclamptic women with H. pylori. The association of H. pylori with preeclampsia needs to be further explored.

Helicobacter pylori infection and related factors among pregnant women at Debre Tabor General Hospital, Northwest Ethiopia, 2021: Anemia highly related with H. pylori

INTRODUCTION

Infection with Helicobacter pylori is one of the most frequent chronic bacterial illnesses in humans. Pregnant mothers are the populations most vulnerable to H. pylori infection. The objective of this study was to assess the prevalence of H. pylori infection and associated factors among pregnant mothers having antenatal care at Debre Tabor General Hospital, Debre Tabor, Ethiopia, 2021.

METHODS AND MATERIALS

Institutional based cross-sectional study design was conducted on 290 pregnant women. The stool antigen test is used to detect the active presence of the H. pylori antigen in the feces. Bivariate and multivariable logistic regression analyses were carried out to assess potential factors responsible for H. pylori infection. Variables associated with the prevalence of H. pylori infection with (p-value < 0.05) were considered statistically significant.

RESULTS

The prevalence of H. pylori infection was 17.9%, with 95% (CI: 13.4%-22.3%). In all, 65.4% of H. pylori infection positive mothers had gastrointestinal problems and developed symptoms like abdominal cramp and diarrhea 1 (1.92%), loss of appetite 10 (19.23%), hiccups 9 (17.31%), abdominal pain which worsens when the stomach is empty 19 (36.54%), indigestion, and frequent heart burn 13 (25%) during the present pregnancy. Lesser frequency of handwashing practice AOR = 3.09, 95% CI (1.14-8.34), use of soap for handwashing AOR = 0.44, 95% CI (0.19-0.98), eating unwashed vegetables and fruits AOR = 2.279, 95% CI (1.03-5.04), and not being anemic AOR = 0.268, 95% CI (0.10- 0.71), were significantly associated with H. pylori infection.

CONCLUSIONS

This study shows that the prevalence of H. pylori infection among pregnant women was low compared with that of the general population. Although in the lower prevalence, the level of anemia was strongly associated with the prevalence of H. pylori infection. This implies that H. pylori infection is a public health problem.

Barriers to Health Workers in Iron Deficiency Anemia Prevention among Indonesian Pregnant Women

Background

Anemia is a global maternal health problem that commonly occurs in developing countries. During pregnancy, a woman will receive antenatal services to check her condition and prevent complications. This study aimed to explore barriers towards achieving eradication of iron deficiency anemia among pregnant women in Aceh Besar District, Indonesia.

Methods

This qualitative study was conducted on 18 health workers who were recruited through a purposive sampling method. Data were collected through in-depth interviews using open-ended questions to gain insight about participants' experiences in managing iron deficiency anemia among pregnant women. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview's result.

Result

Three main themes emerged: (1) facilities, infrastructures, and supplement support; (2) sociocultural factors; and (3) health provider competency deficits and no developing guidelines.

Conclusion

Our findings provide understanding that there are many obstacles and barriers encountered by health workers in iron deficiency anemia prevention management. Thus, the management of anemia must be supported by a skilled health worker and quality facilities. Health workers and pregnant women must work together to achieve optimal management of anemia prevention.