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Published in: BMC Gastroenterology 1/2012

Open Access 01-12-2012 | Research article

A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

Authors: Sara Fill Malfertheiner, Maximilian V Malfertheiner, Siegfried Kropf, Serban-Dan Costa, Peter Malfertheiner

Published in: BMC Gastroenterology | Issue 1/2012

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Abstract

Background

Symptoms of gastro-esophageal reflux disease (GERD) in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed.

Methods

We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3). Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ). Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7) was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy.

Results

The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%.
Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI.

Conclusion

GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief.
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Literature
1.
go back to reference Darba J, Kaskens L, Plans P, Elizalde JI, Coma M, Cuomo R: Epidemiology and societal costs of gastroesophageal reflux disease and Barrett's syndrome in Germany, Italy and Spain. Expert Rev Pharmacoecon Outcomes Res. 2011, 11 (2): 225-232. 10.1586/erp.11.5.CrossRefPubMed Darba J, Kaskens L, Plans P, Elizalde JI, Coma M, Cuomo R: Epidemiology and societal costs of gastroesophageal reflux disease and Barrett's syndrome in Germany, Italy and Spain. Expert Rev Pharmacoecon Outcomes Res. 2011, 11 (2): 225-232. 10.1586/erp.11.5.CrossRefPubMed
2.
go back to reference Nocon M, Keil T, Willich SN: Prevalence and sociodemographics of reflux symptoms in Germany–results from a national survey. Aliment Pharmacol Ther. 2006, 23 (11): 1601-1605. 10.1111/j.1365-2036.2006.02924.x.CrossRefPubMed Nocon M, Keil T, Willich SN: Prevalence and sociodemographics of reflux symptoms in Germany–results from a national survey. Aliment Pharmacol Ther. 2006, 23 (11): 1601-1605. 10.1111/j.1365-2036.2006.02924.x.CrossRefPubMed
3.
go back to reference Nocon M, Labenz J, Jaspersen D, Leodolter A, Richter K, Vieth M, et al: Health-related quality of life in patients with gastro-oesophageal reflux disease under routine care: 5-year follow-up results of the ProGERD study. Aliment Pharmacol Ther. 2009, 29 (6): 662-668. 10.1111/j.1365-2036.2008.03921.x.CrossRefPubMed Nocon M, Labenz J, Jaspersen D, Leodolter A, Richter K, Vieth M, et al: Health-related quality of life in patients with gastro-oesophageal reflux disease under routine care: 5-year follow-up results of the ProGERD study. Aliment Pharmacol Ther. 2009, 29 (6): 662-668. 10.1111/j.1365-2036.2008.03921.x.CrossRefPubMed
4.
go back to reference Fill S, Malfertheiner M, Costa SD, Monkemuller K: Handling of the gastroesophageal reflux disease (GERD) during pregnancy--a review. Z Geburtshilfe Neonatol. 2007, 211 (6): 215-223. 10.1055/s-2007-981336.CrossRefPubMed Fill S, Malfertheiner M, Costa SD, Monkemuller K: Handling of the gastroesophageal reflux disease (GERD) during pregnancy--a review. Z Geburtshilfe Neonatol. 2007, 211 (6): 215-223. 10.1055/s-2007-981336.CrossRefPubMed
5.
go back to reference Richter JE: Review article: the management of heartburn in pregnancy. Aliment Pharmacol Ther. 2005, 22 (9): 749-757. 10.1111/j.1365-2036.2005.02654.x.CrossRefPubMed Richter JE: Review article: the management of heartburn in pregnancy. Aliment Pharmacol Ther. 2005, 22 (9): 749-757. 10.1111/j.1365-2036.2005.02654.x.CrossRefPubMed
6.
go back to reference Bainbridge ET, Temple JG, Nicholas SP, Newton JR, Boriah V: Symptomatic gastro-oesophageal reflux in pregnancy. A comparative study of white Europeans and Asians in Birmingham. Br J Clin Pract. 1983, 37 (2): 53-57.PubMed Bainbridge ET, Temple JG, Nicholas SP, Newton JR, Boriah V: Symptomatic gastro-oesophageal reflux in pregnancy. A comparative study of white Europeans and Asians in Birmingham. Br J Clin Pract. 1983, 37 (2): 53-57.PubMed
7.
go back to reference Baron TH, Richter JE: Gastroesophageal reflux disease in pregnancy. Gastroenterol Clin North Am. 1992, 21 (4): 777-791.PubMed Baron TH, Richter JE: Gastroesophageal reflux disease in pregnancy. Gastroenterol Clin North Am. 1992, 21 (4): 777-791.PubMed
8.
go back to reference Bor S, Kitapcioglu G, Dettmar P, Baxter T: Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2007, 5 (9): 1035-1039. 10.1016/j.cgh.2007.05.003.CrossRefPubMed Bor S, Kitapcioglu G, Dettmar P, Baxter T: Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2007, 5 (9): 1035-1039. 10.1016/j.cgh.2007.05.003.CrossRefPubMed
9.
go back to reference Fill Malfertheiner S, Malfertheiner MV, Monkemuller K, Roehl FW, Malfertheiner P, Costa SD: Gastroesophageal reflux disease and management in advanced pregnancy: a prospective survey. Digestion. 2009, 79 (2): 115-120. 10.1159/000209381.CrossRefPubMed Fill Malfertheiner S, Malfertheiner MV, Monkemuller K, Roehl FW, Malfertheiner P, Costa SD: Gastroesophageal reflux disease and management in advanced pregnancy: a prospective survey. Digestion. 2009, 79 (2): 115-120. 10.1159/000209381.CrossRefPubMed
10.
go back to reference Ho KY, Kang JY, Viegas OA: Symptomatic gastro-oesophageal reflux in pregnancy: a prospective study among Singaporean women. J Gastroenterol Hepatol. 1998, 13 (10): 1020-1026. 10.1111/j.1440-1746.1998.tb00564.x.CrossRefPubMed Ho KY, Kang JY, Viegas OA: Symptomatic gastro-oesophageal reflux in pregnancy: a prospective study among Singaporean women. J Gastroenterol Hepatol. 1998, 13 (10): 1020-1026. 10.1111/j.1440-1746.1998.tb00564.x.CrossRefPubMed
11.
go back to reference Ramu B, Mohan P, Rajasekaran MS, Jayanthi V: Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol. 2011, 30 (3): 144-147. 10.1007/s12664-010-0067-3.CrossRefPubMed Ramu B, Mohan P, Rajasekaran MS, Jayanthi V: Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol. 2011, 30 (3): 144-147. 10.1007/s12664-010-0067-3.CrossRefPubMed
12.
go back to reference Rey E, Rodriguez-Artalejo F, Herraiz MA, Sanchez P, Alvarez-Sanchez A, Escudero M, et al: Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study. Am J Gastroenterol. 2007, 102 (11): 2395-2400. 10.1111/j.1572-0241.2007.01452.x.CrossRefPubMed Rey E, Rodriguez-Artalejo F, Herraiz MA, Sanchez P, Alvarez-Sanchez A, Escudero M, et al: Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study. Am J Gastroenterol. 2007, 102 (11): 2395-2400. 10.1111/j.1572-0241.2007.01452.x.CrossRefPubMed
13.
go back to reference Lind JF, Smith AM, McIver DK, Coopland AT, Crispin JS: Heartburn in pregnancy–a manometric study. Can Med Assoc J. 1968, 98 (12): 571-574.PubMedPubMedCentral Lind JF, Smith AM, McIver DK, Coopland AT, Crispin JS: Heartburn in pregnancy–a manometric study. Can Med Assoc J. 1968, 98 (12): 571-574.PubMedPubMedCentral
14.
go back to reference Knudsen A, Lebech M, Hansen M: Upper gastrointestinal symptoms in the third trimester of the normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 1995, 60 (1): 29-33. 10.1016/0028-2243(95)02069-1.CrossRefPubMed Knudsen A, Lebech M, Hansen M: Upper gastrointestinal symptoms in the third trimester of the normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 1995, 60 (1): 29-33. 10.1016/0028-2243(95)02069-1.CrossRefPubMed
15.
go back to reference Castro Lde P: Reflux esophagitis as the cause of heartburn in pregnancy. Am J Obstet Gynecol. 1967, 98 (1): 1-10.CrossRefPubMed Castro Lde P: Reflux esophagitis as the cause of heartburn in pregnancy. Am J Obstet Gynecol. 1967, 98 (1): 1-10.CrossRefPubMed
16.
go back to reference Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J: Heartburn of pregnancy. Gastroenterology. 1977, 72 (4 Pt 1): 666-668.PubMed Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J: Heartburn of pregnancy. Gastroenterology. 1977, 72 (4 Pt 1): 666-668.PubMed
17.
go back to reference Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006, 101 (8): 1900-1920. 10.1111/j.1572-0241.2006.00630.x. quiz 43CrossRefPubMed Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006, 101 (8): 1900-1920. 10.1111/j.1572-0241.2006.00630.x. quiz 43CrossRefPubMed
18.
go back to reference Nocon M, Kulig M, Leodolter A, Malfertheiner P, Willich SN: Validation of the reflux disease questionnaire for a german population. Eur J Gastroenterol Hepatol. 2005, 17 (2): 229-233. 10.1097/00042737-200502000-00015.CrossRefPubMed Nocon M, Kulig M, Leodolter A, Malfertheiner P, Willich SN: Validation of the reflux disease questionnaire for a german population. Eur J Gastroenterol Hepatol. 2005, 17 (2): 229-233. 10.1097/00042737-200502000-00015.CrossRefPubMed
19.
go back to reference Ali RA, Egan LJ: Gastroesophageal reflux disease in pregnancy. Best Pract Res Clin Gastroenterol. 2007, 21 (5): 793-806. 10.1016/j.bpg.2007.05.006.CrossRefPubMed Ali RA, Egan LJ: Gastroesophageal reflux disease in pregnancy. Best Pract Res Clin Gastroenterol. 2007, 21 (5): 793-806. 10.1016/j.bpg.2007.05.006.CrossRefPubMed
20.
go back to reference Pasternak B, Hviid A: Use of proton-pump inhibitors in early pregnancy and the risk of birth defects. N Engl J Med. 2010, 363 (22): 2114-2123. 10.1056/NEJMoa1002689.CrossRefPubMed Pasternak B, Hviid A: Use of proton-pump inhibitors in early pregnancy and the risk of birth defects. N Engl J Med. 2010, 363 (22): 2114-2123. 10.1056/NEJMoa1002689.CrossRefPubMed
21.
go back to reference Gill SK, O'Brien L, Einarson TR, Koren G: The safety of proton pump inhibitors (PPIs) in pregnancy: a meta-analysis. Am J Gastroenterol. 2009, 104 (6): 1541-1545. 10.1038/ajg.2009.122. quiz 0, 6CrossRefPubMed Gill SK, O'Brien L, Einarson TR, Koren G: The safety of proton pump inhibitors (PPIs) in pregnancy: a meta-analysis. Am J Gastroenterol. 2009, 104 (6): 1541-1545. 10.1038/ajg.2009.122. quiz 0, 6CrossRefPubMed
22.
go back to reference Majithia R, Johnson DA: Are proton pump inhibitors safe during pregnancy and lactation. Drugs. 2012, 72 (2): 171-179. 10.2165/11597290-000000000-00000.CrossRefPubMed Majithia R, Johnson DA: Are proton pump inhibitors safe during pregnancy and lactation. Drugs. 2012, 72 (2): 171-179. 10.2165/11597290-000000000-00000.CrossRefPubMed
Metadata
Title
A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy
Authors
Sara Fill Malfertheiner
Maximilian V Malfertheiner
Siegfried Kropf
Serban-Dan Costa
Peter Malfertheiner
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2012
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-12-131

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