Effect Of Helicobacter Pylori Infection On Pregnancy Related Diseases And Pregnancy Outcomes In Patients With Diabetes In Pregnancy

1.Background and ObjectiveAt present,DM has become a major threat to public health.With the increasing incidence rate of diabetes mellitus(DM),and the widespread attention in pre-pregnancy and in pregnancy screening,the number of diabetes in pregnancy(DIP)is increasing.DIP patients may have adverse pregnancy outcomes due to poor blood glucose control or poor blood glucose monitoring before and during pregnancy.Hp is the most common infection bacteria in the digestive system.Pregnant women may be more susceptible to Hp.Hp infection may participate in the pathogenesis of pregnancy diseases through different mechanisms.Many reports show that the Hp infection rate of DM patients is higher.For DIP patients,hyperglycemia and Hp infection may further promote the occurrence and development of adverse pregnancy outcomes.Therefore,the study of Hp infection in DIP patients is of great significance.The purpose of this study is to explore the effect of Hp infection on pregnancy related diseases and pregnancy outcomes of DIP patients.2.Objects and methodsMethods:A total of 313 pregnant wome,which had regular prenatal examination in the Second Affiliated Hospital of Zhengzhou University from January to December2019,were selected and divided into pregestational diabetes mellitus(PGDM)group(n=40),gestational diabetes mellitus(GDM)group(n=102)and control group(n=171),according to medical history and OGTT screening results at 24-28 weeks of pregnancy.After entering the study group,venous blood was drawn in the morning on an 8 hour empty stomach to detect Hp serum antibody.Each group was further divided into two subgroups:Hp positive group and Hp negative group.The patients were followed up by telephone every month,and the gestational weeks,weight,heart rate,blood pressure,blood glucose,glycosylated hemoglobin,liver and kidney function,blood routine,urine routine,fetal development at different gestational weeks,hyperemesis gravidarum,termination of pregnancy and gestational weeks of termination of pregnancy,abortion,stillbirth,neonatal weight,and body length were carefully recorded.SPSS 23.0 software was used for statistical analysis.The measurement data were expressed as mean±standard deviation((?)±s).T-test was used for comparison between the two groups;One-way ANOVA was used for comparison between multiple groups;LSD-t method were used for pairwise comparison between multiple groups;χ~2test was used for count data.P<0.05 for the difference was statistically significant.3.Results1.About Hp infection rate,DIP patients have no significant difference from normal pregnant women(P>0.05);DIP patients are significantly higher than control group in type I Hp infection rate(P<0.05).2.Comparison of HP positive and HP negative subgroups in each group:In control group,GDM group and PGDM group,the delivery time,fetal meridian value(head circumference,abdomen circumference)at the end of pregnancy,neonatal weight and length of Hp positive group were significantly lower than those of Hp negative group(P<0.05);The incidence of hyperemesis gravidarum,gestational hypertension,pre-eclampsia,premature birth and abortion of Hp positive group were significantly higher than those in Hp negative group(P<0.05).The fatal meridian value(head circumference,abdomen circumference,femur length)during the second trimester and the incidence of anemia and thrombocytopenia was no significant difference from the Hp negative group(P>0.05).3.Comparison of Hp positive subgroups of each group:GDM-Hp positive group and PGDM-Hp positive group’s delivery time,fetal meridian value(head circumference,abdomen circumference)at the end of pregnancy,newborn weight and length were significantly lower than those of the control-Hp positive group(P<0.05);The incidence of hyperemesis gravidarum,gestational hypertension,pre-eclampsia,premature birth and abortion in the GDM-Hp positive group and PGDM-Hp positive group were significantly higher than those of the control-Hp positive group(P<0.05);The fatal meridian value(head circumference,abdomen circumference,femur length)during the second trimester and the incidence of anemia and thrombocytopenia was no significant difference from the control-Hp positive group(P>0.05).4.Conclusions1.The prevalence of Hp infection in pregnant women is high,and the infection rate of type I Hp is higher in the DIP group than in the normal pregnant women group.2.For DIP patients,Hp may increase the risk of pregnancy-related diseases(including hyperemesis gravidarum,pre-eclampsia,pregnancy-induced hypertension,etc.)and adverse pregnancy outcomes(including fetal growth restriction,miscarriage,premature delivery).