Levels of antibodies against cytomegalovirus and Chlamydophila pneumoniae are increased in early onset pre-eclampsia.
OBJECTIVE
The origins of pre-eclampsia/eclampsia lie in a mismatch between feto-placental demands and utero-placental supply, a situation that also arises in normotensive intrauterine growth restriction (IUGR). Could reactivated chronic infection be both a trigger for these differential maternal responses to the same underlying pathology and a link between pre-eclampsia and its attendant lifelong risks of atherosclerosis?


METHODS
Nested case-control study.


METHODS
Tertiary obstetric centre.


METHODS
Cases of pre-eclampsia, normotensive IUGR and controls.


METHODS
A nested case-control study of serum from a population-based bank was performed. Seroprevalence and levels of anti-cytomegalovirus (CMV) and Chlamydophila pneumoniae immunoglobulin G (IgG) were compared (non-parametrically) between women with early onset pre-eclampsia (<34 weeks of gestation, n = 9), late onset pre-eclampsia (> or =34 + 0 weeks of gestation, n = 29), normotensive IUGR (birthweight less than third centile, n = 33) and matched normal pregnancy (n = 113, up to 2 per case).


RESULTS
There was a significant difference in both anti-CMV and Chl. pneumoniae antibodies between groups (Kruskal-Wallis test, P < 0.05). Women with early onset pre-eclampsia had higher anti-CMV levels (median: 79, 95% confidence interval [95% CI] = 47, 164) than women with late onset pre-eclampsia (26 [95% CI = 22, 82], P < 0.05), normotensive IUGR (40 [95% CI = 31, 72], P < 0.05) and normal pregnancy (49 [95% CI = 45, 70], P < 0.05). Women with normotensive IUGR had significantly lower anti-Chl. pneumoniae antibodies (0.10 [95% CI = 0.08, 0.38]) than did normal pregnancy controls (0.21 [95% CI = 0.20, 0.28], P <0.05).


CONCLUSIONS
The anti-CMV and anti-Chl. pneumoniae antibodies were higher in early onset pre-eclampsia than in late onset pre-eclampsia, normotensive IUGR and normal pregnancy. This may provide a pathophysiological link between pre-eclampsia and the known increased risk for subsequent atherosclerosis.
von Dadelszen
Peter
P
Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of British Columbia, University of British Columbia, 2H30-4500 Oak Street, Vancouver, BC, Canada V6H 3N1.
Magee
Laura A
LA
Krajden
Mel
M
Alasaly
Kadria
K
Popovska
Vesna
V
Devarakonda
Rajashree M
RM
Money
Deborah M
DM
Patrick
David M
DM
Brunham
Robert C
RC
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D023521:Chlamydophila Infections / Q000150:complications / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D011225:Pre-Eclampsia / Q000276:immunology / Q000382:microbiology* / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000382:microbiology* / Q000821:virology; D011446:Prospective Studies
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007074:Immunoglobulin G