THE ASSOCIATION BETWEEN HELICOBACTER PYLORI INFECTION AND GROWTH IN CHILDREN LESS THAN 18 MONTHS OF AGE

Background: Helicobacter pylori colonizes the stomach and causes chronic gastritis that remains mostly asymptomatic. In a fraction of the infected people, H. pylori causes peptic ulcers and gastric cancer. Although the infection is acquired during childhood, its impact on children’s health remains poorly understood. Conflicting findings exist on the association between H. pylori infection and children`s growth.

Aims: To examine the association between H. pylori infection and children`s growth in healthy infants up to 18 months of age.

Methods: A cohort study was conducted in 2007-2008 among 231 healthy Arab infants from 2 Arab villages of different socioeconomic status. Infants, aged 1-9 weeks at enrollment, were followed until age 18 months. Sociodemographic information, pre and peri-natal history were obtained. Anthropometric measurements were performed at age 2, 4, 6, 8, 12 and 18 months, and stool samples were collected at the same visits. H. pylori detection was performed using an antigen detection enzyme immunoassay in fecal specimens.

Results: H. pylori infection at age 12 months was associated with significantly lower mean height-for-age Z score at age 18 months compared to uninfected children who lived in the low socioeconomic status village. This association was significant after adjustment for potential confounders such as breastfeeding, hemoglobin level, and household crowding conditions. The slope of linear growth between ages 6 and 18 months was smaller in the infected group, implying a slower growth, compared to the uninfected group. Such patterns were not observed in relation to ponderal growth.

Conclusions: H. pylori infection acquired in early life might negatively affect children`s linear growth in low socioeconomic status communities.