Increased Susceptibility toHelicobacter pyloriInfectionin Pregnancy

[摘要] Objective: Helicobacter pyloriplays, a major role in abdominal symptoms and gastroduodenal pathology, including gastric cancer. Pregnancy has been associated with changes in both humoral and cell-mediated immunity. These changes include alterations in the various classes of antibodies during different gestational periods. It has been previously suggested that these alterations mayexpose pregnant women to an increased risk of infection with this microorganism.Methods:To further investigate this hypothesis, we assayed sera from 229 asymptomatic pregnant women for the presence ofH.-pylori-specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies by means of a commercially available serum ELISA test (Malakit™, Biolab, Belgium). Both tests were previously validated in large series ofH.-pylori-positive and -negative subjects. While the presence ofH.-pylori-specific IgG antibodies is only a marker for a “chronic” infection with this bacterium and therefore no indicator of the time of acquisition of the infection,specific IgM antibodies are a more specific marker for a recently acquired infection withH. pylori. Results were compared with those previously obtained in asymptomatic, healthy, nonpregnant individuals.Results:One hundred twenty of 229 women (52.4%) and 55/118 nonpregnant subjects (46.6%) were seropositive forH.-pylori-specific IgG antibodies (P> 0.3). Out of these 120 IgG-antibodypositive women, 36 (30%) were positive forH.-pylori-specific IgM antibodies, as were 25/109 (22.9%) in the IgG-antibody-negative group (P> 0.3). Overall, 61/229 (26.6%) of the pregnant women had recently been infected withH. pylori, compared with 11% of the healthy, nonpregnant population (P> 0.01).Conclusions:Our observations confirm the possibility of an increased susceptibility toH. pyloriinfection in pregnancy. Additional studies are necessary to further understand the immune response toH. pyloriin pregnancy. Infect. Dis. Obstet. Gynecol. 7:195–198, 1999.

[学科分类] 妇产科学