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Volume 198, Issue 1, Pages 7-22 (January 2008)


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Maternal infection and risk of preeclampsia: Systematic review and metaanalysis

Agustín Conde-Agudelo, MD, MPHa, José Villar, MD, MPHb, Marshall Lindheimer, MDc

Received 22 March 2007; received in revised form 29 June 2007; accepted 24 July 2007.

There are lingering questions regarding the association between maternal infection and preeclampsia. Systematic review and metaanalysis was conducted of observational studies that examined the relationship between maternal infection and preeclampsia. Forty-nine studies met the inclusion criteria. The risk of preeclampsia was increased in pregnant women with urinary tract infection (pooled odds ratio, 1.57; 95% CI, 1.45-1.70) and periodontal disease (pooled odds ratio, 1.76; 95% CI, 1.43-2.18). There were no associations between preeclampsia and presence of antibodies to Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus, treated and nontreated HIV infection, and malaria. Individual studies did not find a relationship between herpes simplex virus type 2, bacterial vaginosis, and Mycoplasma hominis and preeclampsia. Urinary tract infection and periodontal disease during pregnancy are associated with an increased risk of preeclampsia. More studies are required to verify this as well as to explore whether or not such relationships are causal and, if so, the mechanisms involved.

a Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Baltimore, MD, and Detroit, MI

b Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, UK

c Department of Obstetrics & Gynecology and Medicine, The University of Chicago, Chicago, IL.

 Reprints not available from the authors.

 This study was supported by the United Nations Development Programme/United Nations Population Fund/World Health Organization/World Bank Special Program of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

 The views expressed in this document are solely the responsibility of the authors and do not necessarily represent the views of the World Health Organization or its Member States.

PII: S0002-9378(07)00919-2

doi:10.1016/j.ajog.2007.07.040


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