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Helicobacter pylori
Helicobacter pylori infection and micronutrient deficiency in pregnant women: a systematic review and meta-analysis
  1. Md. Nure Alam Afsar1,
  2. Zannatun Nahar Jhinu2,
  3. Md. Aminul Islam Bhuiyan2,
  4. Zhahirul Islam1,
  5. Towfida Jahan Siddiqua3
  1. 1Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, ICDDRB, Dhaka, Bangladesh
  2. 2Department of Zoology, University of Dhaka, Dhaka, Bangladesh
  3. 3Nutrition and Clinical Services Division, ICDDRB, Dhaka, Bangladesh
  1. Correspondence to Dr Towfida Jahan Siddiqua; towfida{at}icddrb.org

Abstract

Background Over the last few years, epidemiological studies have shown that infection with Helicobacter pylori has a major effect on micronutrient deficiency as well as on adverse pregnancy outcomes. Importantly, there are gaps in understanding the linkage of H. pylori infection with micronutrients deficiency in pregnant women.

Objective We conducted a systematic review and meta-analysis to estimate the association between H. pylori infection and micronutrient deficiencies in pregnant women.

Methods A systematic literature search was conducted for relevant articles using PubMed, Web of Science, and Scopus database from inception to March 2020. The OR with 95% CIs was determined by meta-analysis of data extracted from the selected studies.

Results From 2384 primary articles, 6 studies were selected for systematic reviews and 4 studies distinctively (with 1274 participants: 553 cases and 721 controls) were selected for meta-analysis. The meta-analysed fixed effect model estimated the odds of having H. pylori infection was not significantly higher among pregnant women with micronutrient deficiencies than those without deficiencies (OR=1.12, 95% CI 0.88 to 1.42, p=0.37). In the subgroup analysis, no correlation was found between H. pylori infection and vitamin B12 (OR=0.74, 95% CI 0.45 to 1.21, p=0.22), folate (OR=1.07, 95% CI 0.73 to 1.58, p=0.73), and ferritin (OR=0.81, 95% CI 0.51 to 1.31, p=0.4). However, a positive correlation was found between iron-deficiency anaemia (IDA) and H. pylori infection (OR=16.23, 95% CI 4.19 to 62.93, p<0.0001) during pregnancy.

Conclusion H. pylori infection is associated with increased risk of IDA but not with deficiency of other micronutrients in pregnancy.

PROSPERO registration number CRD42019135683.

  • vitamins
  • micronutrients
  • Helicobacter pylori
  • meta-analysis
  • malabsorption
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjgast-2020-000490

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    Footnotes

    • Contributors All authors contributed to the protocol for this work. MNAA performed study design, data collection, data analysis, data interpretation and drafting of the manuscript. ZNJ did data collection, data interpretation and critical review of the paper. MAIB and ZI contributed the critical revision of the manuscript. TJS performed study conception, data interpretation, critical revision of the manuscript and supervision of the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. We do not have any other available data. However, additional data are available upon reasonable request from the reviewer.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.