Associative connection of infectious and inflammatory diseases in pregnancy and severe preeclampsia

Materials and methods. This retrospective case-control study enrolled 50 women with severe preeclampsia and 50 control women with spontaneous singleton pregnancy. Median age of women ranged from 20 to 35 years. All women did not have a history of hypertension, autoimmune, metabolic, renal, or cardiac diseases, and preeclampsia before this pregnancy. We have analyzed χ², odds ratio (OR) and its 95% confidence intervals (95% Cl). Results. We found significant association between maternal systemic infectious and severe preeclampsia (OR = 49.6; 95% Cl 13.05-188.64). The risk of severe preeclampsia were significantly lower in patients with local infections of the lower genital tract (OR = 4.5; 95% Cl 1.49-6.71). Asymptomatic bacteriuria is associated with the highest risk of severe preeclampsia (OR = 17.0; 95% Cl 4.66-61.81). Acute gravidarum pyelonephritis showed lower association with severe preeclampsia (OR = 5.4; 95% Cl 1.69-10.54). We did not observe increased risk of severe preeclampsia with acute respiratory infections (OR = 2.0; 95% Cl 0.71-4.69). Acute non-specific bacterial vaginitis and acute candidiasis vulvovaginitis were found to be risk factors of severe preeclampsia (OR = 6.7; 95% Cl 1.90-11.02 and OR = 4.3; 95% Cl 1.45-9.99 respectively). Cytomegalovirus infection (2 %), toxoplasmosis (2 %), Chlamydia trachomatis cervicitis (4 %), acute Trichomonas colpitis (2 %) and bacterial vaginosis (4 %) were found only in patients with severe preeclampsia. Conclusion. Our data support that acute maternal infection is associated with an increased risk of severe preeclampsia in healthy women with singleton pregnancy. Systemic inflammatory response might be the main potential mechanisms related to infections and enhanced development of severe preeclampsia. Further research is required to elucidate the underlying mechanism of this association.

preeclampsia, maternal infection, systemic inflammatory response

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