ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378
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Systemic and Local Infections in Pregnancy as an Epigenetic Factor in the Development of Severe Pre-eclampsia

DOI:10.31550/1727-2378-2018-150-6-6-10
Bibliography link: Belokrinitskaya T. E., Frolova N. I., Anokhova L. I., Kolmakova K. A., Pletnyova V. A. Systemic and Local Infections in Pregnancy as an Epigenetic Factor in the Development of Severe Pre-eclampsia. Doctor.Ru. 2018; 6(150): 6–10.
Systemic and Local Infections in Pregnancy as an Epigenetic Factor in the Development of Severe Pre-eclampsia
10 September 09:34

Study Objective: To assess the risk of severe pre-eclampsia (PE) in pregnant women with acute infections during pregnancy and a genetic predisposition to PE.

Study Design: This was a retrospective case-control study.

Materials and Methods: Fifty women with severe PE (main group) and 50 women with an uncomplicated pregnancy (comparison group), aged 20 to 35, were enrolled in the study. All patients had a spontaneous singleton pregnancy, were similar in social status and parity, had no history of PE, hypertension, kidney disease, or cardiovascular, autoimmune, or metabolic disorders, and had the AGTR1- 1166CC and/or NOS3-894ТТ genetic polymorphisms (predictors of PE). Genetic polymorphisms were studied using polymerase chain reaction with real-time detection of amplification products. The statistical significance of differences between the groups was assessed by the Student test and the χ2 test. Statistically significant differences were defined as values of χ2 > 3.84 and р ≤ 0.05. The strength of association between infection in pregnancy and the frequency of severe PE was determined by the odds ratio (OR) with a 95% confidence interval (CI).

Study Results: The study showed that women with systemic infections were at significantly higher risk for PE (OR 49.6; 95% CI: 13.05-188.64) than those with local infections of the lower reproductive tract (OR 4.5; 95% CI: 1.49-6.71). Women with asymptomatic bacteriuria were at the highest risk for PE (OR 17.0; 95% CI: 4.66-61.81). Those with gestational pyelonephritis were at a significantly lower risk (OR 5.4; 95% CI: 1.69-10.54), while in the group of women with acute respiratory infections risk for PE was statistically insignificant (OR 2.0; 95% CI: 0.71-4.69). Cytomegalovirus infection (2%) and toxoplasmosis (2%) during pregnancy were reported only in women with severe PE. Among the women with local infections, the highest risk for PE was associated with acute non-specific bacterial vaginitis caused by mixed flora (opportunistic pathogens) (OR: 6.7; 95% CI: 1.90-11.02). Lower risk was associated with acute Candida vulvovaginitis (OR: 4.3; 95% CI: 1.45-9.99). Only patients with severe PE had cervicitis caused by Chlamydia trachomatis (4%), acute trichomonal vaginitis (2%), and bacterial vaginosis (4%) during pregnancy.

Conclusion: These data show that infections during pregnancy are a significant epigenetic risk factor for severe PE in patients with a genetic predisposition to hypertension complications during gestation. A clinically and economically effective strategy for reducing the frequency of severe PE and the maternal and perinatal complications and losses it causes should be based on the prevention, early diagnosis, and prompt and appropriate treatment of bacterial, viral, and parasitic infections in pregnant women.

T. E. Belokrinitskaya — Chita State Academy of Medicine. E-mail: tanbell24@mail.ru

N. I. Frolova — Chita State Academy of Medicine. E-mail: taasyaa@mail.ru

L. I. Anokhova — Chita State Academy of Medicine. E-mail: pochta@chitgma.ru

K. A. Kolmakova — Chita State Academy of Medicine. E-mail: pochta@chitgma.ru

V. A. Pletnyova — Chita State Academy of Medicine. E-mail: pochta@chitgma.ru



Systemic and Local Infections in Pregnancy as an Epigenetic Factor in the Development of Severe Pre-eclampsia
10 September 09:34
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