The effect of Helicobacter pylori infection on pregnancy and fetal complications: a systematic review and meta-analysis.
Samira Ahmadi, Parya Ardalani, Sara Ahmadi et al.
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In 30 seconds
This systematic review and meta-analysis pooled observational cohort and case-control studies of maternal Helicobacter pylori infection and pregnancy outcomes. Across 25 studies, infection was associated with higher risks of preeclampsia, gestational diabetes, hyperemesis gravidarum, preterm birth, and small for gestational age. The largest reported association was with hyperemesis gravidarum (RR 5.57, 95% CI 3.43-9.04). The authors describe the findings as exploratory and hypothesis-generating because the evidence was observational and showed heterogeneity and small-study effects.
Key findings
- H. pylori infection was associated with preeclampsia (RR 2.06, 95% CI 1.42-3.01).
- Associations were reported for gestational diabetes (RR 1.42, 95% CI 1.00-2.03) and hyperemesis gravidarum (RR 5.57, 95% CI 3.43-9.04).
- Infection was associated with preterm birth (RR 1.30, 95% CI 1.14-1.49) and small for gestational age (RR 1.18, 95% CI 1.03-1.36).
- The evidence comprised observational studies, with substantial heterogeneity and small-study effects for several outcomes.
Why it matters
The pooled findings suggest that maternal H. pylori infection may be associated with several clinically important pregnancy outcomes. However, associations from observational studies cannot establish that infection causes these outcomes, and methodological variation and small-study effects limit confidence. The results identify questions for better-designed research rather than establishing a basis for routine screening or treatment during pregnancy.
What to keep in mind
All included evidence was observational; substantial between-study heterogeneity and small-study effects were reported for several outcomes.