The association between Helicobacter pylori seropositivity and low birthweight in a Sudanese maternity hospital

Maternal Undernutrition and Low Birth Weight in a Tertiary Hospital in Sudan: A Cross-Sectional Study

BACKGROUND

The World Health Organization set a Global Nutrition Target of a 30% reduction in LBW by 2025. Maternal malnutrition/undernutrition is among the most important modifiable risk factors for impaired fetal growth. This study investigates the effect of maternal undernutrition on LBW in Sudan.

METHODS

A cross-sectional study was conducted at Saad Abuelela Hospital in Khartoum, Sudan, from May to October 2020. The sociodemographic and obstetric data of the women were gathered via questionnaire, and their mid-upper arm circumference (MUAC) was measured. Maternal undernutrition was defined as a MUAC of <23 cm.

RESULTS

In total, 1,505 pairs of pregnant women and their newborns were enrolled in the study. The medians [interquartile (IQR)] of the age, parity, and gestational age were 27.0 (9.0) years, 1.0 (3.0), and 38.0 (2.0) weeks, respectively. The median (IQR) of the birth weight was 3,028.0 (690.0) g. Of the 1,505 participants, 182 (12.1%) delivered LBW infants. Multivariate logistic regression showed that MUAC [adjusted odds ratio (AOR) = 0.91, 95% confidence interval (CI) = 0.87-0.96] and gestational age (AOR = 0.79, 95% CI = 0.73-0.85) were negatively associated with LBW. The level of antenatal care <2 visits (AOR = 2.10, 95% CI = 1.30-3.57) was associated with LBW. Women with undernutrition were at a higher risk of delivering LBW infants (AOR = 1.66, 95% CI = 1.09-2.53).

CONCLUSION

LBW is a health problem in Sudan, and women with undernutrition were at a higher risk of delivering LBW infants.

Maternal H. pylori seropositivity is associated with gestational hypertension but is irrelevant to fetal growth and development in early childhood

BACKGROUND

Helicobacter 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.

METHODS

In 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.

RESULTS

Of 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.

CONCLUSIONS

Maternal 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.

Review: Helicobacter pylori and extragastric diseases

In the last year, many studies have demonstrated a potential role of Helicobacter pylori in the pathogenic mechanisms of different extragastric diseases. While the role of H pylori in idiopathic thrombocytopenic purpura, idiopathic iron deficiency anemia, and vitamin B12 deficiency has already been demonstrated, there is growing evidence of other related conditions, especially cardiovascular, metabolic, and neurologic disorders, including neurodegenerative diseases. A summary of the results of the most relevant studies published over the last year on this attractive topic is presented in this review.