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; preeclampsia; pregnant women.