Preconception Helicobacter pylori infection might adversely affect pregnancy outcome

Abstract

Background: The association between H. pylori infection, and adverse pregnancy outcomes is still controversial, and no available guidelines recommend screening for H. pylori infection before and/or during pregnancy. Objectives: To detect the incidence of Helicobacter pylori (H. pylori) in Egyptian pregnant women, and the adverse pregnancy outcomes associated with H. pylori infection. Methods: Data of 305 pregnant women with regular antenatal follow-up, and complete delivery records were finally analyzed in study to detect the incidence of H. pylori in Egyptian pregnant women, and the adverse pregnancy outcomes associated with H. pylori infection. The collected blood samples from the studied participants during the antenatal care were used for detection of anti-H. Pylori IgG. Participants were categorized according to anti-H. Pylori IgG to either H. Pylori-positive (study group), or H. Pylori-negative controls. Participants were followed-up in the antenatal clinics till delivery to detect any adverse outcome either during pregnancy and/or during delivery [i.e., hyperemesis gravidarum, iron deficiency anemia, preeclampsia, gestational diabetes mellitus, and preterm deliveries]. Results: The incidence of hyperemesis gravidarum, iron deficiency anemia, preeclampsia, gestational diabetes mellitus, and preterm deliveries was significantly higher in the studied H. Pylori-positive group (8.5%, 34.9%, 6.98%,13.18%, and 10.9% respectively) compared to H. Pylori-negative controls (1.14%, 19.3%, 1.7%, 3.4%, and 3.98%respectively), (P=0.002, 0.01, 0.02, 0.003, and 0.02, respectively). The H. Pylori-positive group had significantly higher odds, and risks of hyperemesis gravidarum [OR 8.1 (P=0.007), and RR 7.5 (P=0.008)], iron deficiency anemia [OR 2.2 (P=0.002), and RR 1.8 (P=0.002)], and preeclampsia [OR 4.3 (P=0.03), and RR 4.1 (P=0.03)] compared to H. Pylori-negative controls. The H. Pylori-positive group had also significantly higher odds, and risks of gestational diabetes mellitus [OR 4.3 (P=0.002), and RR 3.9 (P=0.003)], and preterm deliveries [OR 2.9 (P=0.02), and RR 2.7 (P=0.02)] compared to H. Pylori-negative controls. Conclusion: The incidence of hyperemesis gravidarum, iron deficiency anemia, preeclampsia, gestational diabetes mellitus, and preterm deliveries was significantly higher in the studied H. Pylori-positive participants compared to non-infected controls. The H. Pylori-positive group had significantly higher odds, and risks of hyperemesis gravidarum, iron deficiency anemia, preeclampsia, gestational diabetes mellitus, and preterm deliveries compared to H. Pylori-negative controls.

The association of Helicobacter pylori with adverse pregnancy outcomes in three European birth cohorts

“…Different mechanisms are suggested about how the pathogen complicates pregnancies, including chronic in ammation (in gestational diabetes), suboptimal placental development (in preeclampsia) and micronutrient depletion (in fetal growth restriction) 9 . Moreover, during pregnancy, physiological immunological adaptations could activate a latent H.pylori infection and accelerate disease processes related to pregnancy disorders 10 . The association of H.pylori with perinatal mental disorders (depression and anxiety) has not been studied.…”