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Medline ® Abstract for Reference 58

of 'Treatment regimens for Helicobacter pylori'

Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review.
Golberg D, Szilagyi A, Graves L
Obstet Gynecol. 2007;110(3):695.
OBJECTIVE: To systematically review studies examining the relationship between hyperemesis gravidarum and Helicobacter pylori (H pylori) infection.
DATA SOURCES: A 1966 to January 2007 search using MEDLINE/PubMed, EMBASE, and Web of Science included MeSH terms: "Helicobacter pylori," "Helicobacter infections," "hyperemesis gravidarum," and the text words "nausea," "vomit," "pregnancy," and "Helicobacter." References of selected papers were examined for additional relevant studies.
METHODS OF STUDY SELECTION: We evaluated studies investigating a relationship between hyperemesis gravidarum and H pylori infection. Studies were included in which the diagnosis of hyperemesis gravidarum was made at or before entry into the study, and H pylori diagnosis was made by serum antibody sample, gastric biopsy, saliva test, or stool sample. The search produced 169 titles; 22 were reviewed in further detail.
TABULATION, INTEGRATION, AND RESULTS: Fourteen case-control studies met established criteria, involving 1,732 participants and controls tested for H pylori infection. Studies were evaluated according to patient demographics and study methodology (case definition, exclusion criteria, H pylori testing). An estimate of the odds ratios with 95% confidence intervals was calculated by using a random effects model for dichotomous variables with review article software. Ten studies showed a significant association between hyperemesis gravidarum and H pylori infection. Odds ratios varied from 0.55 to 109.33; three results were less than 1.0. Tests for heterogeneity applied to several subgroups were considerable with values above 75% for all groups.
CONCLUSION: An association between hyperemesis gravidarum and H pylori infection is suggested by this systematic review. However, the considerable heterogeneity among studies highlights study limitations.
Department of Family Medicine, SMBD Jewish General Hospital, McGill University, Montreal, Canada. dgolberg@her.jgh.mcgill.ca