Helicobacter pylori Infection Is a Risk Factor for Severe Hyperemesis Gravidarum Requiring Prolonged Hospitalization

This retrospective study investigated the relationship between Helicobacter pylori (H. pylori) infection and prolonged hospitalization in patients with severe hyperemesis gravidarum (HG). We also aimed to identify other factors associated with extended hospital stays.

We analyzed data from 164 patients with severe HG. The patients were initially divided into two groups based on their anti-H. pylori IgG antibody status (positive vs. negative). Subsequently, a second analysis stratified all patients into a short-stay group (< 21 days) and a long-stay group (≥ 21 days).

Patients who were positive for anti-H. pylori IgG antibodies had significantly longer hospital stays (median 24 vs. 15 days, p = 0.032). In a univariate analysis, anti-H. pylori IgG positivity, higher serum free thyroxine (FT4) levels, and strong urine ketone positivity were all significantly associated with long-term hospitalization. In the subsequent multivariate analysis, anti-H. pylori IgG positivity emerged as an independent risk factor for prolonged hospitalization (odds ratio 4.67, 95% CI 1.61-13.49, p = 0.004). Although strongly positive urine ketones were also associated with longer hospital stays (median 19 vs. 12 days, p = 0.001), this was not identified as an independent risk factor (odds ratio 2.169, 95% CI 0.97-4.85, p = 0.059).

Our findings suggest that testing for anti-H. pylori IgG antibodies may help identify patients at a higher risk for a longer hospital stay due to severe HG. Pregnant women who test positive for anti-H. pylori IgG antibodies may benefit from closer monitoring. Additionally, these results raise the possibility that preconception care could be a preventive measure.