Helicobacter Pylori Infection and Vitamin B12 Deficiency During Early Pregnancy in an Urban Slum in Bangladesh (P24-035-19)

Abstract

Abstract Objectives Helicobacter pylori (H. pylori), an inflammatory gastric bacterial infection is prevalent worldwide and may impair the absorption of many micronutrients, particularly iron and vitamin B12. We measured H. pylori infection status in the extracted stool sample in pregnant women and examined its associations with biomarkers of vitamin B12 (B12) status. Methods In a blinded-placebo controlled trial, Bangladeshi women (n = 160, 18–35 years, gestational weeks 9–14, Hb > 70 g/L) were randomized to receive either B12 (100 μg/day) fortified or control milk throughout pregnancy up to 6-mo postpartum. Baseline data of the trial were used to conduct this analysis. Blood and stool samples were collected from all participants at enrollment. Folate, B12 and total homocysteine (tHcy) in plasma were measured by electrochemiluminescence immunoassay. Plasma active-B12 was determined by enzyme linked immunosorbent assay and H. pylori antigen in feces was measured by enzyme immunoassay. Results The mean hemoglobin concentration of women was 116.5 ± 10.2 g/L and 25.6% had anemia (Hb < 110 g/L). About 6.25% of the women were B12 deficient (150 pmol/L) and 29.38% had marginal status (150–220 pmol/L). The mean active B12 concentration was 43.3 ± 22.4 pmol/L and 39.38% (<35 pmol/L) were at risk of B12 deficiency. Elevated tHcy was found in 34.1% of the women (>8 μmol/L) and 3.8% had low plasma folate (<3.1 ng/mL). The majority of the participants (65%) had fecal H. pylori antigen, indicating asymptomatic carriage state. Presence of H. pylori antigen was accompanied by B12 deficiency in ̴23% of the women. Logistic regression analysis revealed that the odds of having H. pylori antigen was lower in women with increasing age [OR: 0.89 (95% CI: 0.81, 0.96); p-value = 0.005]. However, the results showed no significant association between B12 markers and H. pylori infection. Conclusions The high prevalence of H. pylori infection co-exists with micronutrient deficiencies during early pregnancy in an urban slum in Bangladesh, meriting more comprehensive approaches for their evaluation and prevention. Funding Sources Nestle Foundation.