Adverse reproductive outcomes in urban women with adeno-associated virus-2 infections in early pregnancy.
BACKGROUND
We demonstrated recently that adeno-associated virus-2 (AAV-2) DNA was detected significantly more frequently in placental trophoblast cells from cases of severe pre-eclampsia than from normal term deliveries. Here, we sought to determine if maternal AAV-2 infection early in pregnancy preceded adverse outcomes resulting from placental dysfunction.


METHODS
We collected first trimester maternal serum samples and compared anti-AAV-2 IgM antibody levels (indicating primary infection or reactivation of latent AAV-2) between controls delivered at term (n = 106) and three groups of cases: spontaneous abortions (n = 34), spontaneous preterm deliveries (n = 24) and women with at least one outcome usually attributed to placental dysfunction, including pre-eclampsia, intrauterine growth restriction (IUGR) or stillbirth (n = 20). The seroprevalence of immunoglobulin G (IgG) antibodies against AAV-2 and IgM antibodies against viruses that promote AAV-2 replication [adenovirus and cytomegalovirus (CMV)] were also determined.


RESULTS
First trimester maternal IgM seropositivity was 5.6 times more prevalent among pre-eclampsia/IUGR/stillbirth cases (P = 0.0004) and 7.6 times more prevalent among preterm deliveries (P < 0.0001) than among controls. CMV and adenovirus IgM antibodies and chronic AAV-2 infections (IgG seropositivity) were not associated with adverse pregnancy outcomes.


CONCLUSIONS
Primary or reactivated AAV-2 infection (maternal IgM seropositivity) early in pregnancy was associated with adverse reproductive outcomes associated with placental dysfunction, including pre-eclampsia, stillbirth and spontaneous preterm delivery.
Arechavaleta-Velasco
F
F
Center for Research on Reproduction and Women's Health, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Gomez
L
L
Ma
Y
Y
Zhao
J
J
McGrath
C M
CM
Sammel
M D
MD
Nelson
D B
DB
Parry
S
S
D000256:Adenoviridae / Q000276:immunology; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D003587:Cytomegalovirus / Q000276:immunology; D000229:Dependovirus; D005260:Female; D005317:Fetal Growth Retardation / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D010322:Parvoviridae Infections / Q000097:blood / Q000503:physiopathology*; D010920:Placenta / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D050497:Stillbirth; D014505:Urban Population
D007074:Immunoglobulin G; D007075:Immunoglobulin M