Low incidence of hypertensive disorders of pregnancy in women treated with spiramycin for toxoplasma infection.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
Our results suggest that antibiotic treatment during pregnancy can reduce the incidence of PIH, thus opening new perspectives in its prevention and therapy.
Todros
T
T
Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy. tullia.todros@unito.it
Verdiglione
P
P
Oggè
G
G
Paladini
D
D
Vergani
P
P
Cardaropoli
S
S
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000517:prevention & control*; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D015572:Spiramycin / Q000627:therapeutic use*; D014123:Toxoplasmosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D015572:Spiramycin