Alberta Health Services, Calgary, AB, T3A 0P6, Canada.
Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA.
Matern Child Health J. 2022 Oct;26(10):2040-2049. doi: 10.1007/s10995-022-03484-5. Epub 2022 Aug 6.
Some research has suggested a possible role for past infection in the development of preeclampsia. The objective of this study was to explore the role of Helicobacter pylori, cytomegalovirus, and Chlamydophila pneumoniae in the development of preeclampsia in a prospective pregnancy sample.
We conducted a nested case-control study in The Archive for Child Health (ARCH), a pregnancy cohort of 867 unselected women enrolled at the first prenatal visit with archived blood and urine in pregnancy. We matched 21 cases of preeclampsia to 52 unaffected controls on maternal age (±4 years), race, parity, and gestational age at blood draw. Using conditional logistic regression, we examined the association between preeclampsia status and immunoglobulins G (IgG) tested by indirect ELISA to each of the three microorganisms, adjusting for potential confounders.
No significant difference was found between cases and controls. The unadjusted odds ratio was 1.5 (95%CI: 0.2-9.1), 0.6 (95%CI: 0.2-1.9), and 1.9 (95%CI: 0.6-5.6) for H. pylori, cytomegalovirus and C. pneumoniae respectively. After controlling for confounders analysis found increased odds of H. pylori IgG (AOR: 1.9; 95% CI: 0.2-15.3) and C. pneumoniae IgG (AOR: 2.3; 95% CI: 0.6-9.2) for preeclampsia, albeit being not significant. Conversely, cytomegalovirus IgG had lower odds for preeclampsia (AOR: 0.4; 95% CI: 0.1-1.7).
Past infection with H. pylori, and C. pneumoniae in early pregnancy showed a higher risk of preeclampsia, but the findings failed to achieve statistical significance. Cytomegalovirus was not associated with preeclampsia in these data. These preliminary findings encourage future research in populations with high prevalence of these infections.
一些研究表明过去的感染可能与子痫前期的发生有关。本研究旨在探讨幽门螺杆菌、巨细胞病毒和肺炎衣原体在前瞻性妊娠样本中对子痫前期发生的作用。
我们在 The Archive for Child Health (ARCH) 中进行了一项巢式病例对照研究，该研究是一个 867 名未经选择的孕妇队列，在第一次产前检查时采集了血液和尿液，并在妊娠期间进行了存档。我们根据母亲年龄（±4 岁）、种族、产次和采血时的孕龄，将 21 例子痫前期病例与 52 例未受影响的对照进行了匹配。使用条件逻辑回归，我们在调整了潜在混杂因素后，检测了间接 ELISA 检测到的三种微生物中每一种与子痫前期状态之间的关联。
病例组与对照组之间没有发现显著差异。未经调整的比值比分别为 H. pylori（幽门螺杆菌）1.5（95%CI：0.2-9.1）、巨细胞病毒 0.6（95%CI：0.2-1.9）和肺炎衣原体 1.9（95%CI：0.6-5.6）。在控制了混杂因素后，发现 H. pylori IgG（优势比：1.9；95%置信区间：0.2-15.3）和 C. pneumoniae IgG（优势比：2.3；95%置信区间：0.6-9.2）对子痫前期的发生有较高的几率，但无统计学意义。相反，巨细胞病毒 IgG 对子痫前期的发生几率较低（优势比：0.4；95%置信区间：0.1-1.7）。
妊娠早期感染 H. pylori 和 C. pneumoniae 与子痫前期的发生风险增加有关，但这些发现未达到统计学意义。在这些数据中，巨细胞病毒与子痫前期无关。这些初步发现鼓励在这些感染流行率高的人群中进行进一步的研究。
