Karachaliou Marianna, Chatzi Leda, Michel Angelika, Kyriklaki Andriani, Kampouri Mariza, Koutra Katerina, Roumeliotaki Theano, Chalkiadaki Georgia, Stiakaki Eftichia, Pawlita Michael, Waterboer Tim, Kogevinas Manolis, de Sanjose Silvia
Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
Molecular Diagnostics of Oncogenic Infections Department, Infection and Cancer Programme, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Paediatr Perinat Epidemiol. 2017 Jul;31(4):374-384. doi: 10.1111/ppe.12374. Epub 2017 Jun 22.
Limited evidence exists on the association between exposure to Helicobacter pylori infection early in life, including fetal life, and neurodevelopment in childhood.
We used prospective data on 352 mother-child pairs and cross-sectional data on 674 children to assess the association of maternal and child's H. pylori seropositivity correspondingly on child's neurodevelopment at age four in the Rhea birth cohort in Crete, Greece. Blood levels of immunoglobulin G antibodies to 12 H. pylori proteins were measured using multiplex serology. Child's neurodevelopment at age four was assessed using the McCarthy Scales of Children's Abilities. Linear regression models were used to explore the associations after adjusting for potential confounders.
Helicobacter pylori seroprevalence (95% CI) in cord blood, representing maternal status, was 41.5% (36.3%, 46.8%) and in 4 years old children was 6.5% (95% CI 4.8%, 8.7%). Children of H. pylori seropositive mothers had lower score in the general cognitive (-3.87, 95% CI -7.02, -0.72), verbal (-2.96, 95% CI -6.08, 0.15), perceptual performance (-3.37, 95% CI -6.60, -0.15), quantitative (-2.85, 95% CI -6.28, 0.58), and memory scale (-3.37, 95% CI -6.67, -0.07) compared to those of seronegative mothers. Seropositivity in cord blood specifically to GroEl and NapA - two of the 12 H. pylori proteins investigated - was associated with lower scores in almost all scales. At age four, H. pylori seropositive children performed worst in neurodevelopment assessment compared to their seronegative counterparts although no association reached statistically significant level.
Helicobacter pylori infection in early life may be an important but preventable risk factor for poor neurodevelopment.
关于生命早期（包括胎儿期）暴露于幽门螺杆菌感染与儿童神经发育之间的关联，现有证据有限。
我们使用了352对母婴的前瞻性数据以及674名儿童的横断面数据，以评估希腊克里特岛瑞亚出生队列中母亲和儿童幽门螺杆菌血清阳性与儿童4岁时神经发育的相应关联。使用多重血清学方法测量针对12种幽门螺杆菌蛋白的免疫球蛋白G抗体的血液水平。使用麦卡锡儿童能力量表评估儿童4岁时的神经发育情况。在调整潜在混杂因素后，使用线性回归模型探索关联。
代表母亲状况的脐带血中幽门螺杆菌血清阳性率（95%置信区间）为41.5%（36.3%，46.8%），4岁儿童中为6.5%（95%置信区间4.8%，8.7%）。与血清阴性母亲的孩子相比，幽门螺杆菌血清阳性母亲的孩子在一般认知（-3.87，95%置信区间-7.02，-0.72）、语言（-2.96，95%置信区间-6.08，0.15）、感知表现（-3.37，95%置信区间-6.60，-0.15）、定量（-2.85，95%置信区间-6.28，0.58）和记忆量表（-3.37，95%置信区间-6.67，-0.07）方面得分较低。脐带血中针对所研究的12种幽门螺杆菌蛋白中的GroEl和NapA这两种蛋白的血清阳性与几乎所有量表得分较低相关。4岁时，与血清阴性的儿童相比幽门螺杆菌血清阳性儿童在神经发育评估中表现最差，尽管没有关联达到统计学显著水平。
生命早期的幽门螺杆菌感染可能是神经发育不良的一个重要但可预防的风险因素。
