Nourollahpour Shiadeh Malihe, Riahi Seyed Mohammad, Adam Ishag, Saber Vafa, Behboodi Moghadam Zahra, Armon Bahram, Spotin Adel, Nazari Kangavari Hajar, Rostami Ali
a Department of Midwifery and Reproductive Health , Nursing and Midwifery School, Tehran University of Medical Sciences , Tehran , Iran.
b Department of Midwifery and Reproductive Health , Nursing and Midwifery School, Mazandaran University of Medical Sciences , Sari , Iran.
J Matern Fetal Neonatal Med. 2019 Jan;32(2):324-331. doi: 10.1080/14767058.2017.1378331. Epub 2017 Sep 19.
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.
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 χ-based Q-test and I statistic.
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 (χ = 13.39; I = 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; χ = 6.42; I = 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; χ = 1.83; I = 0, 95% CI: 0-90).
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.
幽门螺杆菌与许多妊娠不良影响有关，如子痫前期（PE）。我们进行了这项系统评价和荟萃分析研究，以评估幽门螺杆菌感染与子痫前期之间可能存在的关联，这是第一项阐明该问题的荟萃分析。
检索了PubMed、ISI（科学引文索引）、SCOPUS和谷歌学术数据库（截至2017年4月）以确定相关研究。本研究采用流行病学观察性研究的荟萃分析以及系统评价和荟萃分析方案的首选报告项目指南。使用随机效应荟萃分析模型估计合并比值比（OR）和95%置信区间（CI）。用基于χ的Q检验和I统计量评估异质性。
共有八项研究（包括889名参与者，460名单纯子痫前期女性和429名对照）符合纳入标准。发现幽门螺杆菌感染与子痫前期之间存在正相关（OR：3.35；95%CI：2.21-5.10）。异质性可接受（χ = 13.39；I = 47.7，95%CI：0-77）。在亚组分析中，当采用免疫印迹法时，细胞毒素相关抗原A血清阳性是子痫前期的一个重要危险因素（OR：11.12；95%CI：5.34-23.16；χ = 6.42；I = 53.3, 95%CI：0-85），而当采用酶联免疫吸附测定（ELISA）作为检测方法时，它不是子痫前期的潜在危险因素（OR：1.11；95%CI：0.6-2.06；χ = 1.83；I = 0，95%CI：0-90）。
本研究表明，与未感染幽门螺杆菌的女性相比，感染幽门螺杆菌的女性，尤其是感染细胞毒素相关基因A（Cag A）阳性菌株者更易患子痫前期
