title: Q fever and pregnancy: experience from the Limoges Regional University Hospital.
abstract: Q fever is an ubiquitous zoonosis caused by Coxiella burnetii. Its tropism for the uterus is a potential source of obstetric complications.
  
  
  
  We describe the obstetric consequences of Q fever diagnosed during pregnancy from a series of cases. When an antenatal diagnosis was made, antibiotic therapy with roxithromycin (Rulid(®)) was started until delivery.
  
  
  
  Between 2007 and 2012, 30 patients were treated for Q fever diagnosed during pregnancy, i.e. 1.9 cases per 1000 people. The most common reasons for performing serology was intrauterine growth retardation, preterm labor and oligoamnios. Q fever was diagnosed as acute and chronic in 26 and 4 cases, respectively. Progression to chronic disease occurred in 8 % of acute forms of the diseases. The prevalence of obstetric complications was 66 %, including 10 % foetal deaths, 31 % preterm delivery and 27 % low birthweight <10th percentile. The obstetric complication rate amongst the 22 patients treated with ante partum macrolides was 60, 30 % of which involved prematurity and 33 % involved low growth. No cases of foetal death were found on treatment and no congenital malformation and placental or neonatal injury was found. No case of disease reactivation was diagnosed in the eight patients who became pregnant again.
  
  
  
  Q fever during pregnancy is responsible for severe obstetric complications. It must be diagnosed early and its clinical forms known in order to start appropriate antibiotic therapy.
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France. perrinemazeau@yahoo.fr.
authors.forename: Perrine
authors.initials: P
authors.lastname: Coste Mazeau
authors.affiliation: Limoges Regional University Hospitals, Virology Unit, 2 Avenue Martin Luther King, 87042, Limoges Cedex 1, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Hantz
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Eyraud
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France.
authors.forename: Lorène
authors.initials: L
authors.lastname: Donadel
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France.
authors.forename: Aymeline
authors.initials: A
authors.lastname: Lacorre
authors.affiliation: Limoges Regional University Hospitals, Virology Unit, 2 Avenue Martin Luther King, 87042, Limoges Cedex 1, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Rogez
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Aubard
authors.affiliation: Limoges Regional University Hospitals, Department of Gynaecology and Obstetrics, Mother and Children's Hospital, 8 avenue Dominique Larrey, 87000, Limoges, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Gauthier
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D016997:Coxiella burnetii / Q000302:isolation & purification; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D006785:Hospitals, University; D006801:Humans; D007752:Obstetric Labor, Premature / Q000209:etiology; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology*; D011296:Prenatal Diagnosis; D015995:Prevalence; D011778:Q Fever / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Coxiella burnetii; Macrolides; Obstetric complications; Pregnancy; Q fever