Helicobacter pylori's virulence and infection persistence define pre-eclampsia complicated by fetal growth retardation.
OBJECTIVE
To better understand the pathogenic role of Helicobacter pylori (H. pylori) in pre-eclampsia (PE), and whether it is associated or not with fetal growth retardation (FGR).


METHODS
Maternal blood samples were collected from 62 consecutive pregnant women with a diagnosis of PE and/or FGR, and from 49 women with uneventful pregnancies (controls). Serum samples were evaluated by immunoblot assay for presence of specific antibodies against H. pylori antigens [virulence: cytotoxin-associated antigen A (CagA); ureases; heat shock protein B; flagellin A; persistence: vacuolating cytotoxin A (VacA)]. Maternal complete blood count and liver enzymes levels were assessed at delivery by an automated analyzer.


RESULTS
A significantly higher percentage of H. pylori seropositive women were found among PE cases (85.7%) compared to controls (42.9%, P < 0.001). There were no differences between pregnancies complicated by FGR without maternal hypertension (46.2%) and controls. Importantly, persistent and virulent infections (VacA/CagA seropositive patients, intermediate leukocyte blood count and aspartate aminotransferase levels) were exclusively associated with pre-eclampsia complicated by FGR, while virulent but acute infections (CagA positive/VacA negative patients, highest leukocyte blood count and aspartate aminotransferase levels) specifically correlated with PE without FGR.


CONCLUSIONS
Our data strongly indicate that persistent and virulent H. pylori infections cause or contribute to PE complicated by FGR, but not to PE without feto-placental compromise.
Department of Obstetric and Gynecology, University of Turin, Turin 10126, Italy. simona.cardaropoli@unito.it
Simona
S
Cardaropoli
Alessandro
A
Rolfo
Annalisa
A
Piazzese
Antonio
A
Ponzetto
Tullia
T
Todros
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000209:etiology* / Q000821:virology; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D010920:Placenta / Q000378:metabolism; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology* / Q000821:virology; D011247:Pregnancy / Q000097:blood; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000209:etiology* / Q000503:physiopathology* / Q000821:virology; D055815:Young Adult
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial