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Maternal and Child Health Journal

Published in:

01-03-2008

Association Between Maternal Infections and Preeclampsia: A Systematic Review of Epidemiologic Studies

Authors: Luis O. Rustveld, Sheryl F. Kelsey, Ravi Sharma

Published in: Maternal and Child Health Journal | Issue 2/2008

Abstract

Objectives

A growing body of evidence suggests an association between maternal infection and preeclampsia. To examine the strength of this association, we conducted a comprehensive review of studies published in peer-reviewed journals.

Methods

Data collection for this review involved Medline, Embase, and Cochrane data base searches of published studies since 1964 on the relationship between maternal infection and preeclampsia. Data were abstracted according to predefined inclusion and exclusion criteria. Study population included women with preeclampsia and normotensive mothers with and without bacterial or viral infections. Altogether, thirty two original studies were identified and evaluated for methodological quality, preeclampsia diagnosis and adjustment for well-known preeclampsia confounders. Pooled odds ratios and 95% confidence intervals, according to infection status, were calculated using DerSimonian-Laird random-effects models. Publication bias was assessed with a funnel plot and Egger’s regression asymmetry test.

Results

Sixteen of the 32 studies evaluated were selected for inclusion in the meta-analysis. These studies showed that women with either a bacterial or viral infection were at higher risk of developing preeclampsia, compared to women without infection. Combined results for the 16 studies yielded an OR of 2.1 (95% CI 1.6–2.7). Separate pooled estimates for prospective (OR 2.3, 95% CI 1.7–3.0), case control and retrospective studies combined (OR 2.0, 95% CI 1.4–2.9) yielded similar results. Heterogeneity was significant across overall pooled estimates, case control and retrospective studies (Q_df=20 of 45.7, P = .001; Q_df=10 of 38.7, P < .005, respectively), but not prospective studies (Q_df=9 of 6.5 P = .69).

Conclusions

In our analysis, any infection (bacterial or viral) was associated with a two-fold higher risk of preeclampsia. This association may provide a potential explanation for preeclampsia-related inflammation.

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Title: Association Between Maternal Infections and Preeclampsia: A Systematic Review of Epidemiologic Studies
Authors: Luis O. Rustveld
Sheryl F. Kelsey
Ravi Sharma
Publication date: 01-03-2008
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 2/2008
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-007-0224-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association Between Maternal Infections and Preeclampsia: A Systematic Review of Epidemiologic Studies

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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