Assessment of adverse pregnancy outcomes associated with Helicobacter pylori infection

The background of Helicobacter pylori (H. pylori) infection is complex, and its influence on adverse pregnancy outcomes is inconsistently reported. We performed a multi-institutional, retrospective analysis using de-identified electronic health records from the TriNetX Research Network to compare various pregnancy outcomes in women with and those without H. pylori infection. A 1:1 propensity score matching (PSM) was performed with covariates including age, race, pre-pregnancy body mass index, history of diabetes, presence of gastroesophageal reflux disease nausea, and vomiting. Between January 2010 and October 2024, we identified 5,148 pregnant women with H. pylori infection and 4,740,133 women from the general population with no positive test results or diagnosis for H. pylori. Following PSM, both cohorts contained 5,116 patients each. Our results showed that H. pylori infection was associated with an increased risk of hyperemesis gravidarum. A significant association with hyperemesis gravidarum were also found when comparing patients with positive H. pylori test results to those with negative test results. Secondary outcomes also showed positive correlations between H. pylori infection and low gestational weight gain, fetal growth restriction, and intrauterine fetal demise. Contrarily, the risk of gestational diabetes, preeclampsia and preterm delivery did not increase significantly. Our study confirmed the association between H. pylori infection and multiple adverse pregnancy outcomes. Given its high prevalence, further research is warranted to investigate effective screening and treatment protocols for H. pylori infection during pregnancy.