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Helicobacter pylori Infection in Early Childhood and Growth at School Age
Khitam Muhsen1, Sophy Goren1, Dani Cohen1
1Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Insights
Early childhood Helicobacter pylori infection may stunt school-age linear growth. This study found H. pylori-infected children had lower height-for-age Z scores and slower growth velocity.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Growth and Development
Background:
- Conflicting data exists on Helicobacter pylori's impact on child growth.
- This study investigates H. pylori's effect on growth indices from preschool to school age.
Purpose of the Study:
- To examine the long-term effects of early childhood H. pylori infection on children's growth indices at school age.
Main Methods:
- Prospective study of 139 healthy children (ages 3-5) followed to age 6-9.
- H. pylori stool antigen testing, height, weight, and hemoglobin measurements.
- Analysis of height-for-age, weight-for-age, and BMI-for-age Z scores and growth velocity.
Main Results:
- 53% of children were H. pylori positive at baseline; nearly all remained positive.
- H. pylori-infected children had significantly lower height-for-age Z scores at follow-up (p=.002).
- Slower growth velocity was observed in H. pylori-infected children (p=.014), but weight was unaffected.
Conclusions:
- Early childhood Helicobacter pylori infection may adversely impact linear growth into school age.
- Findings suggest a potential long-term effect of H. pylori on children's physical development.
Background:
There are conflicting results regarding the role of H. pylori in children's growth. We examined differences in growth indices at school age according to H. pylori infection acquisition in preschool age.
Materials And Methods:
A prospective study was undertaken between 2004 and 2009, in which of healthy children (N = 139, ages 3-5 years at baseline) were tested for the presence of H. pylori antigen in their stool using enzyme-linked immunoassay and followed-up till age 6-9 years (median follow-up time 45 months). Height, weight, and hemoglobin levels were measured, and socioeconomic data were obtained. Z scores of height for age, weight for age, and body mass index for age at baseline and follow-up were calculated using the 2000 Center for Disease Control and Prevention growth reference curves. Growth velocity (cm/month) between preschool and school age was compared between H. pylori-infected and uninfected children using mixed models.
Results:
Fifty-three percent of the children were H. pylori positive at baseline, and all except one child tested positive at follow-up. The adjusted mean Z score of height for age at follow-up was significantly lower among H. pylori-infected children than uninfected ones: 0.15 (95% confidence intervals (CIs) 0.02, 0.29) and 0.45 (95% CI 0.29, 0.60), respectively (p = .002). Growth velocity was slower in the former group -0.0264 cm/month (95% CI -0.047, -0.005) (p = .014), after adjusting for baseline height and age. H. pylori infection was not associated with body weight.
Conclusions:
Helicobacter pylori infection acquired in early childhood may have long-term adverse influence on linear growth at school age.
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