Helicobacter pylori detection by stool antigen test in the perinatal period: an inadequate approach to establish maternal transmission

Helicobacter pylori is often acquired during early childhood, and the role of infected mothers in the transmission is crucial (1). Information about spreading during the perinatal period in children in developed countries is sparse and uncertain. Therefore, we attempted to ascertain the possibility of H pylori transmission to newborns. We enrolled 180 mothers (22–37 years; mean 29.3; 8 dropout). Their H pylori status was investigated by serology/stool antigen test (SAT) within 4 days after delivery and 13 C-urea breath test (UBT) within 1 month. Infants were examined by SAT at 1, 6, 12, and 18 months. Only 5 of 172 babies were SAT positive at the first month. Our follow-up results are summarized in Table 1. Three of 5 positive newborns were from negative mothers. Two of them were positive only at the first month, while the remaining newborn was positive until the sixth month. The 2 positive babies from positive mothers remained positive after 6 months, becoming negative only at 1 year. Their fathers showed a positive UBT with a successfully treated clinical history of dyspepsia. Finally, all of the children spontaneously underwent SAT negativity. Our study shows that in the perinatal period a positive finding of SAT is a sporadic event, equally occurring in babies from either positive and negative mothers, undergoing spontaneous negativity within 1 year. These data are complex to explain. It may be argued that H pylori detection by SAT in newborns is an inadequate approach to reveal a vertical transmission. The specificity of this investigation may reach a maximal value of 98.7% (2) in children and, therefore, the possibility that our 5 positive children (2.9%) are mostly false positive is consistent. Subsequently, the rare positivity and the high risk forfalse positive results confirm SAT data by at least another noninvasive test (UBT) for a reliable perinatal screening.