Abstract
BACKGROUND: To investigate the association between Helicobacter pylori infection and insulin resistance and pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). MATERIALS AND METHODS: From 1(st) July 2020 to 31(st) August 2021, a prospective cohort study was conducted on 100 pregnant women with GDM based on 75 gr oral glucose tolerance test results between 24-28 weeks of gestation in Kowsar hospital-a tertiary teaching hospital in Qazvin province, Iran. All enrolled patients underwent testing for H. pylori serum IgG antibody and fasting insulin level. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is computed using fasting blood sugar and fasting serum insulin level, and HOMA-IR ≥2.5 is considered an indicator of insulin resistance. The patient was followed till delivery and evaluated for the incidence of pregnancy complications, including preeclampsia, preterm labor (PTL), need for insulin therapy, and delivery of large for gestational age (LGA) and small for gestational age (SGA) neonates. RESULTS: The frequency of H. pylori infection was 62%. H. pylori seropositivity was associated with elevated serum insulin level (15.88 ± 6.71 Vs 12.86 ± 5.69, P ˂ 0.05) and higher frequency of HOMA-IR ≥2.5 (83.87% Vs 63.16%, P < 0.05). In multivariate analysis, H. pylori seropositivity was the strongest risk factor for HOMA-IR ≥2.5 (OR = 3.263, 95% CI: 1.160- 9.176, P = 0.025). there was no association between H. pylori seropositivity and pregnancy outcomes. In this study, the frequency of LGA was higher among patients with HOMA-Ir ≥2.5 (36.9% Vs 5.7%, P ˂ 0.0001). CONCLUSION: H. pylori infection is prevalent among patients with gestational diabetes and is associated with insulin resistance in this group of pregnant women.