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Prevalence and risk factors for gastroesophageal reflux in pregnancy

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Abstract

Background and aim

Prevalence of gastroesophageal reflux (GER) increases during pregnancy, due to several factors like decreased lower esophageal sphincter pressure, increased intra-abdominal pressure secondary to the enlarged gravid uterus and alteration in gastrointestinal transit. The present study aimed to determine the prevalence of GER in pregnancy in a southern State of the Indian subcontinent and determine the risk factors associated with it.

Methods

Consecutive pregnant females (n = 400) at various stages of pregnancy attending the antenatal clinic or admitted in the antenatal wards were enrolled. Patients with heartburn or regurgitation or both (n = 182) for at least a week were defined as cases, and controls were those without these symptoms (n = 218). Data on demographic variables and symptoms were analyzed using Pearson chi-square, Yates corrected chi-square and Fischer exact test and student independent t-test as appropriate; p < 0.05 was considered significant.

Results

Demographic characteristics between cases and controls were similar. The mean age of cases (23.68±3.37 years) was similar to that of controls (23.25±3.31 years). The overall prevalence of GER was 45.5% (182/400), 77 (19.3%) had heartburn (GER-HB), 54 (13.5%) had regurgitation (GER-R) and 51 (12.8%) had both (GER-HB + R). Age and gravida did not influence the frequency of symptoms. Symptoms were more frequent in the second (43.1%) and third trimester (54.1%) as compared to the first trimester (9.5%) in pregnant women with GER (p < 0.001). Atypical symptoms were uncommon. GER was common among non-vegetarians (p = 0.02) and frequent aerated beverage users (p = 0.001).

Conclusions

GER prevalence was high in pregnancy, often in second and third trimester. Non-vegetarianism and aerated beverages increased the risk of reflux in pregnancy.

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Acknowledgement

We thank Mr Vengatesan A, Lecturer in Statistics, Clinical Epidemiology Unit, Madras Medical College Hospital, Chennai, for statistical assistance.

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Authors and Affiliations

  1. Department of Gastroenterology, Stanley Medical College, Old Jail Road, Royapuram, Chennai, 600 001, India

    Bhavadharini Ramu, Pazhanivel Mohan, Muthu Subramanian Rajasekaran & Venkataraman Jayanthi

  2. Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT, USA

    Bhavadharini Ramu

Authors
  1. Bhavadharini Ramu
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  2. Pazhanivel Mohan
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  3. Muthu Subramanian Rajasekaran
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  4. Venkataraman Jayanthi
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Correspondence to Pazhanivel Mohan.

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Ramu, B., Mohan, P., Rajasekaran, M.S. et al. Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol 30, 144–147 (2011). https://doi.org/10.1007/s12664-010-0067-3

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  • DOI: https://doi.org/10.1007/s12664-010-0067-3

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