Abstract

BackgroundHelicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. However, it is still unknown whether maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and whether this can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development.MethodsIn this prospective cohort study, we recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined as > 12 U/ml of anti-H. pylori IgG in maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA. The growth of the included neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth.ResultsOf the 106 enrolled women, 25 (23.6%) were H. pylori-seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p = 0.04) and lower cord blood levels of IGF-1 (< 35 ng/ml, 70.0% vs. 40.7%, p = 0.02) and IGFBP-3 (< 1120 ng/ml, 100.0% vs. 76.3%, p = 0.02) compared with the seronegative women. No significant impacts on birth weight, childhood growth and cognitive development were found to be correlated with maternal H. pylori seropositivity during pregnancy.ConclusionsMaternal H. pylori infection during pregnancy was more likely to lead to the development of GH, but was not correlated with fetal and childhood growth and development. In addition to close monitoring of hypertension, H. pylori eradication can be considered for mothers with H. pylori infection.

Highlights

  • Helicobacter pylori infection is known to alter growth-related hormones and affect growth in young children

  • Our results suggested that early childhood growth and cognitive development were not affected by maternal H. pylori infection during pregnancy

  • There were missing data during the 3-year follow-up period, which may have led to bias in the results. In this prospective cohort study in Taiwan, we found that maternal H. pylori infection per se did not promote small for gestational age (SGA) in neonates

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Summary

Introduction

Helicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. Primary H. pylori infections occur most commonly in early childhood, with reported annual spontaneous seroreversion rates ranging from 1 to 2% both in children and adults [1, 2]. It seldom causes clinical symptoms in children, chronic H. pylori infection can pose serious health threats, and the bacterium has been reported to promote the development of chronic gastritis, peptic ulcer diseases, MALT lymphoma and gastric cancer in 10% of the infected population. We previously showed that the successful eradication of H. pylori can restore systemic ghrelin levels and improve growth in children [7]

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