Relationship between Helicobacter pylori infection and pre-eclampsia among pregnant women in Ardabil

Abstract

INTRODUCTIONIdentifying health priorities is an essential step in providing health education programs and changes in planning any intervention in the provision of health services and health promotion in society. One of these priorities is reducing maternal mortality. One of the major causes of mortality among pregnant women is preeclampsia, that despite extensive research, the main cause of it is unknown. Pre-eclampsia is multifactorial and many factors such as high blood pressure, obesity (BMI >30), multiple pregnancies, race, ethnicity, socioeconomic factors and genetic predisposition are effective in pre-eclampsia occurrence.1-4 The prevalence of preeclampsia in pregnancy is 5-8% and its incidence is common in nulliparous pregnancy. Suffering from Preeclampsia deal to increase its risk in future pregnancies. Severe and earlier pre-eclampsia deal to higher risk of pre-eclampsia. In fact occur pre-eclampsia before 30th week of pregnancy, increase the risk of its relapse by 40%. Recent studies pointed to effective infections such as cytomegalovirus, Chlamydia, pneumonia and H. pylori in the pathogenesis of pre-eclampsia. 2 In terms of the relationship between H.pylori and pre-eclampsia, there are important points such as: the prevalence of both increases with age and is closely related with the economic and social conditions of individuals. Therefore, by effective treatment of H. pylori, preeclampsia incidence rate can be reduced and also H.pylori can be prevented before pregnancy by screening. 6 According to the estimates, about 25-50% of people in developed countries and 70% in developing countries are infected with H. pylori. 7 ABSTRACTBackground: Studies have shown that certain infections can increase the risk of pre-eclampsia which one of the common infections among pregnant women was H. pylori with prevalence rate of 60-70% in developing countries. The aim of this study was to investigate the association between H. pylori infection and pre-eclampsia among pregnant women. Methods: Blood and stool samples were taken from 108 women with pre-eclampsia and 108 healthy pregnant women. Blood samples analyzed by ELISA for specific antibodies against H. pylori cytotoxin associated gene A (Cag A) antigen and stool samples were studied in terms of the presence of H. pylori Cag A antigen. Collected data were analyzed using statistical methods in SPSS.20. Results: 30 cases (27.8%) of pre-eclampsia women and 34 (31.5%) of healthy women were sero-positive for Cag A antibodies that was not statistically significant difference. Whereas, 67 cases (62.4%) in the case group and 48 cases (44.4%) in the control group had Cag A antigen in stool samples that was statistically significant difference. Conclusions: Results showed that, based on detection of H. pylori antigen in stool samples, frequency of active H. pylori in women with pre-eclampsia was 1.8 times higher than the healthy women.

The risk ofHelicobacter pyloriinfection for adverse pregnancy outcomes: A systematic review and meta‐analysis

“…The primary outcomes we focused on were preeclampsia and fetal growth restriction. Sixteen studies with a total of 10 402 women reported the influence of H pylori infection on the risk of preeclampsia. Pooled results suggested an OR of 2.51 (95% CI: 1.88‐3.34; P < 0.001).…”

“…After conducting subgroup analysis on preeclampsia, fetal growth restriction, gestational diabetes mellitus, and spontaneous abortion, we found the pooled result of seven studies with a total of 4630 participants showed that CagA positivity increased the risk of preeclampsia (OR: 3.61; 95% CI: 1.61‐8.11; P = 0.002). We found that pooled cohort study results with high heterogeneity showed H pylori infection was statistically not associated with preeclampsia ( P = 0.114), fetal growth restriction ( P = 0.138), and spontaneous abortion ( P = 0.401).…”

“…Then, we used the systematic literature search strategy, and 1576 potential relevant studies were identified. After duplication checking, title and abstract screening and full‐text review, 31 full‐text studies were included in the final analysis (Figure ), involving 5 cross‐sectional studies, 17 case‐control studies, and 9 cohort studies, among which 22 studies reached high quality. The main characteristics of included studies were described in Table .…”

“…,26,27,29,[37][38][39][40][42][43][44][46][47][48][49][50] with a total of 10 402 women reported the influence of H pylori infection on the risk of preeclampsia. Pooled results suggested an OR of 2.51 (95% CI: 1.88-3.34; P < 0.001).…”

Helicobacter pylori infection increases the risk of developing preeclampsia: A meta-analysis of observational studies

“…Fourteen studies [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] were finally included in this review, which included a total number of 9787 women. Among them 879 were preeclamptic, while the remaining 8908 were recruited as healthy pregnant controls.…”