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Maternal infection and risk of preeclampsia: systematic review and metaanalysis
Authors:Conde-Agudelo Agustín  Villar José  Lindheimer Marshall
Institution:a Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Baltimore, MD, and Detroit, MI
b Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, UK
c Department of Obstetrics & Gynecology and Medicine, The University of Chicago, Chicago, IL.
Abstract:There are lingering questions regarding the association between maternal infection and preeclampsia. Systematic review and metaanalysis was conducted of observational studies that examined the relationship between maternal infection and preeclampsia. Forty-nine studies met the inclusion criteria. The risk of preeclampsia was increased in pregnant women with urinary tract infection (pooled odds ratio, 1.57; 95% CI, 1.45-1.70) and periodontal disease (pooled odds ratio, 1.76; 95% CI, 1.43-2.18). There were no associations between preeclampsia and presence of antibodies to Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus, treated and nontreated HIV infection, and malaria. Individual studies did not find a relationship between herpes simplex virus type 2, bacterial vaginosis, and Mycoplasma hominis and preeclampsia. Urinary tract infection and periodontal disease during pregnancy are associated with an increased risk of preeclampsia. More studies are required to verify this as well as to explore whether or not such relationships are causal and, if so, the mechanisms involved.
Keywords:maternal infection  periodontal disease  preeclampsia  urinary tract infection
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