Todros T, Verdiglione P, Oggè G, Paladini D, Vergani P, Cardaropoli S
Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy.
Br J Clin Pharmacol. 2006 Mar;61(3):336-40. doi: 10.1111/j.1365-2125.2005.02572.x.
Toxoplasma infection in pregnancy is usually treated with long-term administration of the macrolide spiramycin to prevent fetal malformations. We had empirically observed that treated patients seldom developed pregnancy-induced hypertension (PIH), a common and severe disorder of pregnancy whose aetiology and pathogenesis are still debated. Some clinical and experimental data suggest that infection could play a role in its development.
To test this hypothesis, we studied a cohort of 417 pregnant women treated with spiramycin because of seroconversion for Toxoplasma gondii and 353 low-risk women who did not take any antibiotic during pregnancy. PIH was defined as blood pressure>140/90 mmHg on two or more occasions, occurring after 20 weeks of gestational age.
Seventeen (5.2%) women in the control group developed PIH compared with two (0.5%) in the case group. The odds of developing the disease were significantly lower in the treated subjects (odds ratio=0.092, 95% confidence interval 0.021, 0.399; P<0.001).
Our results suggest that antibiotic treatment during pregnancy can reduce the incidence of PIH, thus opening new perspectives in its prevention and therapy.
孕期弓形虫感染通常采用长期服用大环内酯类抗生素螺旋霉素进行治疗，以预防胎儿畸形。我们凭经验观察到，接受治疗的患者很少发生妊娠期高血压（PIH），这是一种常见且严重的妊娠疾病，其病因和发病机制仍存在争议。一些临床和实验数据表明，感染可能在其发病过程中起作用。
为验证这一假设，我们研究了一组417名因弓形虫血清学转换而接受螺旋霉素治疗的孕妇，以及353名孕期未服用任何抗生素的低风险女性。PIH定义为孕20周后两次或更多次血压>140/90 mmHg。
对照组中有17名（5.2%）女性发生PIH，而病例组中为2名（0.5%）。接受治疗的受试者患该病的几率显著较低（比值比=0.092，95%置信区间0.021，0.399；P<0.001）。
我们的结果表明，孕期抗生素治疗可降低PIH的发生率，从而为其预防和治疗开辟新的前景。
