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Meta-Analysis
. 2020 Oct;7(1):e000490.
doi: 10.1136/bmjgast-2020-000490.

Helicobacter pylori infection and micronutrient deficiency in pregnant women: a systematic review and meta-analysis

Affiliations
Meta-Analysis

Helicobacter pylori infection and micronutrient deficiency in pregnant women: a systematic review and meta-analysis

Md Nure Alam Afsar et al. BMJ Open Gastroenterol. 2020 Oct.

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.

Keywords: Helicobacter pylori; malabsorption; meta-analysis; micronutrients; vitamins.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of study inclusion for systematic review and meta-analysis.
Figure 2
Figure 2
Forest plot of the association between H. pylori infection and micronutrient deficiency.
Figure 3
Figure 3
Funnel plot with estimated 95% CIs for meta-analysis of the effect of H. pylori on micronutrient status. IDA, iron-deficiency anaemia.

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