- Mahrokh Dolatian
- - Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
- Roshanak Noori
- - Department of Midwifery, Faculty of Nursing & Midwifery, Ghouchan Islamic Azad University, Khorasan, Iran
- Homayoun Zojagy
- - Department of Internal, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Hamid Alavimajd
- - Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Received: 10/1/2007 Accepted: 10/1/2007 - Publisher : Avicenna Research Institute
Introduction: Iron deficiency anemia has a high prevalence in women of reproductive age, especially in pregnant women (50%), with serious consequences on the mother and the fetus. Anemia is responsible for about 10-15% of all maternal deaths worldwide. There are different and sometimes contradicting reports on the role of Helicobacter pylori in causing anemia. On the other hand, Helicobacter pylori infection and its well-known complications are of high prevalence in developing countries. Therefore, the present study was conducted to determine the relationship between Helicobacter pylori and anemia. Materials & Methods: This study was retrospectively conducted on 187 pregnant women who were at their third trimester and attended the Health Centers affiliated with Mashad University of Medical Sciences for prenatal care during 2006. Based on hemoglobin assessment done in the first trimester and kept in their health records, the participants were divided into two groups: anemic (94 women) and healthy (93 women) groups. Demographic information and nutrition questionnaires were completed. Tests for hemoglobin, ferritin, and Helicobacter pylori infection, using Elisa method for the detection of IgA and IgG, and antibody titration were conducted. The data from this study were analyzed by SPSS software, version 13, using descriptive (Mean, standard deviation and odds ratio) and inferential statistics (Independent t-test, chi-squared, Mann-Whitney test, analysis of variance and logistic regression). P-values less than 0.05 were considered significant. Results: The subjects in the two groups did not have significant differences in terms of age, job, education, husband's education, husband's job, number of pregnancies and economic status. The rate of Helicobacter pylori infection showed a significant difference between the two anemic and non-anemic groups (p=0.01). It was also shown that hemoglobin concentration and ferritin, during the third trimester of pregnancy in Helicobacter pylori infected cases were lower compared to that of the healthy ones (p<0.001 ). on the other hand, the changes of hemoglobin during the first and the third trimesters of pregnancy in the two groups showed a significant difference (p<0.001). the amount of hemoglobin during the third trimester of pregnancy in the helicobacter pylori infected group had no significant increases in comparison to theirs at the first trimester, despite iron supplementation. conclusion: it seems that there is a relationship between helicobacter pylori infection and anemia in pregnant women, therefore it is suggested that tests for helicobacter pylori infection be included in preconceptional consultations, especially for women who have a history of anemia or persistent anemia, as this will be both wise and economic.< pan>0.001>
Keywords: Pregnancy, Helicobacter pylori, Infections, Anemia, Iron-deficiency, Hemoglobin, Ferritin, First trimester, Third trimester To cite this article:
- Weyermann M, Rothenbacher D, Gayer L, Bode G, Adler G, Grab D, Flock F, Brenner H. Role of Helico-bacter pylori infection in iron deficiency during preg-nancy. Am J Obstet Gynecol. 2005;192(2):548-53.
- Sakabe H, Yagi Y, Kakinoki R, Yoshikawa K, Inoue T, Fujiyama Y. Successful treatment of long-standing iron-deficiency anemia in adults by eradication of Heli-cobacter pylori. Rinsho Ketsueki. 2004;45(5):402-4.
- Kurekci AE, Atay AA, Sarici SU, Yesilkaya E, Senses Z, Okutan V, Ozcan O. Is there a relationship between childhood Helicobacter pylori infection and iron deficiency anemia?. J Trop Pediatr. 2005;51(3):166-9.
- Karimi M, Kadivar R, Yarmohammadi H. Assessment of the prevalence of iron deficiency anemia, by serum ferritin, in pregnant women of Southern Iran. Med Sci Monit. 2002;8(7):CR488-92.
- Cohen JH, Haas JD. Hemoglobin correction factors for estimating the prevalence of iron deficiency anemia in pregnant women residing at high altitudes in Bolivia. Rev Panam Salud Publica. 1999;6(6):392-9.
- Patra S, Pasrija S, Trivedi SS, Puri M. Maternal and perinatal outcome in patients with severe anemia in pregnancy. Int J Gynaecol Obstet. 2005;91(2):164-5.
- عیسیزاده شهلا. بررسی میزان شیوع و عوامل مساعد کننده کم خونی فقر آهن در ماه آخر بارداری مادران مراجعه کننده به مراکز آموزشی- درمانی لقمان حکیم شهر تهران، پایاننامه جهت اخذ درجه کارشناسی ارشد مامایی، دانشگاه پرستاری و مامایی شهید بهشتی سال 1372.
- Levy A, Fraser D, Katz M, Mazor M, Sheiner E. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol. 2005;122(2):182-6.
- Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol. 2006163(2):127-34.
- دیو آلپرز، لاین اویانگ، پارل. بیماریهای اسید پپتیک یامادا. سلیمانی سواد کوهی شهریار. چاپ اول. انتشارات معاونت پژوهشی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی بابل. (1380) صفحات:113-109.
- Peura A. Bacteriology and epidemiology of helicon-bacter pylori infection. Helicobacter. 2005;12(1) :1-7.
- Fennerty MB. Helicobacter pylori: why it still matters in 2005. Cleve Clin J Med. 2005;72 Suppl 2:S1-7.
- Nahon S, Lahmek P, Massard J, Lesgourgues B, Mariaud de Serre N, Traissac L, Bodiguel V, Adotti F, Delas N. Helicobacter pylori-associated chronic gast-ritis and unexplained iron deficiency anemia: a reliable association? Helicobacter. 2003;8(6):573-7.
- Ciacci C, Sabbatini F, Cavallaro R, Castiglione F, Di Bella S, Iovino P, Palumbo A, Tortora R, Amoruso D, Mazzacca G. Helicobacter pylori impairs iron absorp-tion in infected individuals. Dig Liver Dis. 2004;36(7): 455-60.
- Mahalanabis D, Islam MA, Shaikh S, Chakrabarty M, Kurpad AV, Mukherjee S, Sen B, Khaled MA, Ver-mund SH. Haematological response to iron supple-mentation is reduced in children with asymptomatic Helicobacter pylori infection. Br J Nutr. 2005;94(6): 969-75.
- Haberman M, Th. Mayo clinnic internal medicine board review. Dowson, USA. 2003;5:289-295.
- Ogata SK, Kawakami E, Patrício FR, Pedroso MZ, Santos AM. Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infec-tion in symptomatic children and adolescents. Sao Paulo Med J. 2001;119(2):67-71.
- كانينگهام گنت، لونو گيلسترپ، هوث وسترم. بارداري و زايمان ويليامز. قاضي جهاني بهرام، كاظم زاده صونيا، كتابي مهرا. انتشارات گلبان. (1381) 1305-1302.
- Annibale B, Capurso G, Delle Fave G. The stomach and iron deficiency anaemia: a forgotten link. Dig Liver Dis. 2003;35(4):288-95. Review.
- Keenan JI, Peterson RA, Fraser R, Frampton CM, Walmsley TA, Allardyce RA, Roake JA. The effect of Helicobacter pylori infection and dietary iron deficien-cy on host iron homeostasis: a study in mice. Helico-bacter. 2004;9(6):643-50.
- Barabino A. Helicobacter pylori-related iron deficien-cy anemia: a review. Helicobacter. 2002;7(2):71-5.
- Kaffes A, Cullen J, Mitchell H, Katelaris PH. Effect of Helicobacter pylori infection and low-dose aspirin use on iron stores in the elderly. J Gastroenterol Hepa-tol. 2003;18(9):1024-8.
- Idris M, Rehman A. Iron deficiency anemia in mode-rate to severely anemic patient. J Ayub Med Coll Abbotta bad. 2005;17(3):345-349.
- Annibale B, Capurso G, Martino G, Grossi C, Delle Fave G. Iron deficiency anaemia and Helicobacter pylori infection. Int J Antimicrob Agents. 2000;16(4): 515-9.