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. 2013 Sep 3;8(9):e73047.
doi: 10.1371/journal.pone.0073047. eCollection 2013.

Acute maternal infection and risk of pre-eclampsia: a population-based case-control study

Caroline Minassian  1 , Sara L Thomas, David J Williams, Oona Campbell, Liam Smeeth
Affiliations

Acute maternal infection and risk of pre-eclampsia: a population-based case-control study

Caroline Minassian et al. PLoS One. .

Abstract

Background: Infection in pregnancy may be involved in the aetiology of pre-eclampsia. However, a clear association between acute maternal infection and pre-eclampsia has not been established. We assessed whether acute urinary tract infection, respiratory tract infection, and antibiotic drug prescriptions in pregnancy (a likely proxy for maternal infection) are associated with an increased risk of pre-eclampsia.

Methods and findings: We used a matched nested case-control design and data from the UK General Practice Research Database to examine the association between maternal infection and pre-eclampsia. Primiparous women aged at least 13 years and registered with a participating practice between January 1987 and October 2007 were eligible for inclusion. We selected all cases of pre-eclampsia and a random sample of primiparous women without pre-eclampsia (controls). Cases (n=1533) were individually matched with up to ten controls (n=14236) on practice and year of delivery. We calculated odds ratios and 95% confidence intervals for pre-eclampsia comparing women exposed and unexposed to infection using multivariable conditional logistic regression. After adjusting for maternal age, pre-gestational hypertension, diabetes, renal disease and multifetal gestation, the odds of pre-eclampsia were increased in women prescribed antibiotic drugs (adjusted odds ratio 1.28;1.14-1.44) and in women with urinary tract infection (adjusted odds ratio 1.22;1.03-1.45). We found no association with maternal respiratory tract infection (adjusted odds ratio 0.91;0.72-1.16). Further adjustment for maternal smoking and pre-pregnancy body mass index made no difference to our findings.

Conclusions: Women who acquire a urinary infection during pregnancy, but not those who have a respiratory infection, are at an increased risk of pre-eclampsia. Maternal antibiotic prescriptions are also associated with an increased risk. Further research is required to elucidate the underlying mechanism of this association and to determine whether, among women who acquire infections in pregnancy, prompt treatment or prophylaxis against infection might reduce the risk of pre-eclampsia.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Identification of study participants included in the primary analysis: A) cases (n = 1533); B) controls (n = 14236).
See this image and copyright information in PMC

References

    1. Steegers EAP, von Dadelszen P, Duvekot JJ, Pijnenborg R (2010) Pre-eclampsia. Lancet 376: 631–644 doi:10.1016/S0140-6736(10)60279-6 - DOI - PubMed
    1. Trogstad L, Magnus P, Stoltenberg C (2011) Pre-eclampsia: Risk factors and causal models. Best practice & research Clinical obstetrics & gynaecology. doi:10.1016/j.bpobgyn.2011.01.007. - PubMed
    1. Borzychowski AM, Sargent IL, Redman CWG (2006) Inflammation and pre-eclampsia. Seminars in fetal and neonatal medicine 11: 309–316 doi:10.1016/j.siny.2006.04.001 - DOI - PubMed
    1. Noori M, Donald AE, Angelakopoulou A, Hingorani AD, Williams DJ (2010) Prospective study of placental angiogenic factors and maternal vascular function before and after preeclampsia and gestational hypertension. Circulation 122: 478–487 doi:10.1161/CIRCULATIONAHA.109.895458 - DOI - PubMed
    1. Conde-Agudelo A, Villar J, Lindheimer M (2008) Maternal infection and risk of preeclampsia: systematic review and metaanalysis. American journal of obstetrics and gynecology 198: 7–22 doi:10.1016/j.ajog.2007.07.040 - DOI - PubMed

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