Helicobacter pylori infection and risk of preeclampsia: a systematic review and meta-analysis

Abstract

Objective: Helicobacter pylori is associated with many pregnancy adverse effects such as preeclampsia (PE). We performed this systematic review and meta-analysis study to assess the possible association between H. pylori infection and PE and this is the first meta-analysis to clarify this issue.

Methods: PubMed, ISI (Web of Science), SCOPUS, and Google Scholar databases were searched (up to April 2017) to identify the relevant studies. The Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines were used to do this study. Pooled odds ratio (OR) and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. Heterogeneity was assessed with the χ²-based Q-test and I² statistic.

Results: A total of eight studies including 889 participants (460 preeclamptic women and 429 controls) met the eligibility criteria. A positive association was found between H. pylori infection and PE (OR: 3.35; 95% CI: 2.21–5.10). Heterogeneity was acceptable (χ² = 13.39; I² = 47.7, 95% CI: 0–77). In subgroup analysis, cytotoxin-associated antigen A seropositivity was a substantial risk factor for PE when immunoblotting methods (OR: 11.12; 95% CI: 5.34–23.16; χ² = 6.42; I² = 53.3, 95% CI: 0–85) were used, whereas it was not potential risk factor for PE when ELISA was used as a detecting method (OR: 1.11; 95% CI: 0.6–2.06; χ² = 1.83; I² = 0, 95% CI: 0–90).

Conclusions: This study indicated that women with H. pylori infection, especially those infected with Cag A positive strains are more likely to have PE compared with the uninfected women.

Keywords:

• Helicobacter pylori
• cytotoxin-associated antigen A
• pregnant women
• preeclampsia

Acknowledgements

The authors would like to thank Dr. Javad Haroni, for his assistance during the preparation of this manuscript. There are no funding sources for this paper. This study received the approval from the Shahid Beheshti University of Medical Science Ethical Committee. There is no informed consent for this systematic review article.

Disclosure statement

The authors declare that there is no conflict of interests regarding the publication of this paper.