Helicobacter pylori Seropositivity and Childhood Neurodevelopment, the Rhea Birth Cohort in Crete, Greece

Paediatr Perinat Epidemiol. 2017 Jul;31(4):374-384. doi: 10.1111/ppe.12374. Epub 2017 Jun 22.

Abstract

Background: Limited evidence exists on the association between exposure to Helicobacter pylori infection early in life, including fetal life, and neurodevelopment in childhood.

Methods: 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.

Results: 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.

Conclusions: Helicobacter pylori infection in early life may be an important but preventable risk factor for poor neurodevelopment.

Keywords: children; cohort; helicobacter pylori; neurodevelopment; pregnancy.

MeSH terms

  • Adult
  • Child, Preschool
  • Cross-Sectional Studies
  • Developmental Disabilities / epidemiology
  • Developmental Disabilities / etiology*
  • Female
  • Greece / epidemiology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology*
  • Infant, Newborn, Diseases / microbiology
  • Linear Models
  • Male
  • Neuropsychological Tests
  • Pregnancy
  • Prospective Studies
  • Seroepidemiologic Studies