Indian Journal of Gastroenterology

, Volume 30, Issue 3, pp 144–147 | Cite as

Prevalence and risk factors for gastroesophageal reflux in pregnancy

  • Bhavadharini Ramu
  • Pazhanivel MohanEmail author
  • Muthu Subramanian Rajasekaran
  • Venkataraman Jayanthi
Original Article


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.


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.


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).


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


Gastroesophageal reflux Pregnancy 



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

Conflicts of Interest


Funds received



  1. 1.
    Bassy O. Pregnancy and heartburn in Nigerians and Caucasians with theories about aetiology based on manometric recordings from the oesophagus and stomach. Br J Obstet Gynaecol. 1977;84:439–43.CrossRefGoogle Scholar
  2. 2.
    Barr W. Heartburn in pregnancy. J Obstet Gynaecol Br Emp. 1958;65:1019–21.CrossRefGoogle Scholar
  3. 3.
    Bainbridge ET, Temple JG, Nicholas SP, et al. Symptomatic gastro-esophageal reflux in pregnancy: a comparative study of white Europeans and Asians in Birmingham. Br J Clin Pract. 1983;37:53–7.PubMedGoogle Scholar
  4. 4.
    Goh KL. Changing epidemiology of gastroesophageal reflux disease in the Asian-Pacific region: an overview. J Gastroenterol Hepatol. 2004;19 Suppl 3:22–5.CrossRefGoogle Scholar
  5. 5.
    Bor S, Kitapcioglu G, Dettmar P, Baxter T. Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2007;5:1035–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Wu JC. Gastroesophageal reflux disease: an Asian perspective. J Gastroenterol Hepatol. 2008;23:1785–93.PubMedCrossRefGoogle Scholar
  7. 7.
    Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54:710–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Fock KM, Talley NJ, Fass R, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol. 2008;23:8–22.PubMedCrossRefGoogle Scholar
  9. 9.
    Sharma PK, Ahuja V, Madan K, Raizada A, Sharma MP. Prevalence of symptomatic GERD: interim analysis of an adult community-based cross-sectional study. Indian J Gastroenterol. 2004;23 Suppl 2:A11.Google Scholar
  10. 10.
    Kumar S, Karthik Selvaraj M, Jayanthi V. Prevalence of symptoms of gastro-esophageal reflux amongst medical students. Indian J Gastroenterol. 2006;25:168–9.Google Scholar
  11. 11.
    Jayanthi V. Severity of esophagitis in southern Indians. Indian J Gastroenterol. 2002;21:205.PubMedGoogle Scholar
  12. 12.
    Ho KY, Kang JY, Viegas OA. Symptomatic gastro-oesophageal reflux in pregnancy: a prospective study among Singaporean women. J Gastroenterol Hepatol. 1998;13:1020–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Marrero JM, Goggin PM, de Caestecker JS, Pearce JM, Maxwell JD. Determinants of pregnancy heartburn. Br J Obstet Gynaecol. 1992;99:731–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Rey E, Rodriguez-Artalejo F, Herraiz MA et al. Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study. Am J Gastroenterol. 2007;102:2395–400.Google Scholar
  15. 15.
    Klauser AF, Schindlbeck NE, Muller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990;335:205–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Andersen LI, Madsen PV, Dalgaard P, Jensen G. Validity of clinical symptoms in benign esophageal disease, assessed by questionnaire. Acta Med Scand. 1987;221:171–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Baron TH. Gastrointestinal motility disorders during pregnancy. Ann Intern Med. 1993;118:366–75.PubMedGoogle Scholar
  18. 18.
    Al Amri SM. Twenty-four hour pH monitoring during pregnancy and at postpartum: a preliminary study. Eur J Obstet Gynaecol Reprod Biol. 2002;102:127–30.Google Scholar
  19. 19.
    Klinkenberd-Knoll E, Castell DO. Clinical spectrum and diagnosis of gastroesophageal reflux disease. In: Castell DO, editor. The Esophagus. Boston: Little, Brown and Co.; 1993. p. 441–8.Google Scholar

Copyright information

© Indian Society of Gastroenterology 2010

Authors and Affiliations

  • Bhavadharini Ramu
    • 1
    • 2
  • Pazhanivel Mohan
    • 1
    Email author
  • Muthu Subramanian Rajasekaran
    • 1
  • Venkataraman Jayanthi
    • 1
  1. 1.Department of GastroenterologyStanley Medical CollegeChennaiIndia
  2. 2.Department of Internal MedicineUniversity of Connecticut Health CenterFarmingtonUSA

Personalised recommendations