The impact of Helicobacter pylori infection on Pregnancy: A narrative review

Helicobacter pylori infection has systemic inflammatory, metabolic, and endothelial effects beyond the digestive tract. During pregnancy, these mechanisms may contribute to several maternal complications. This review aimed to summarize the extra-digestive impact of H. pylori infection in pregnant women.

A narrative review of the literature was conducted using PubMed and the Cochrane Library. Nineteen studies published up to August 2025 were included.

Three major pregnancy complications were consistently associated with H. pylori infection. First, iron-deficiency anaemia may be aggravated through impaired iron absorption, chronic inflammation, and reduced response to oral supplementation. Second, systemic inflammation and insulin signalling alterations, particularly with virulent strains, may enhance physiological insulin resistance and increase the risk of gestational diabetes mellitus. Third, endothelial dysfunction, oxidative stress, and angiogenic imbalance may contribute to abnormal placentation and preeclampsia. Several studies also reported adverse neonatal outcomes, including lower birth weight and prematurity.

Current evidence suggests that H. pylori infection may contribute to iron-deficiency anaemia, gestational diabetes mellitus, and preeclampsia through interconnected inflammatory and vascular mechanisms. Although causality remains uncertain, targeted screening and individualized monitoring strategies could be considered in selected high-risk pregnant women.