Introduction: Preeclampsia (PE) is a pregnancy related health condition which affects maternal and newborn health significantly. No causative factor has been identified yet. Evidence suggests the role of Helicobacter pylori, cytomegalovirus and Chlamydophila pneumoniae in the development of PE. I conducted this research to explore the role of these microorganisms in the development of PE.Methods:I conducted a nested case-control study by using the ARCH dataset and matched cases with controls on: maternal age (±3 years), maternal race, parity and gestational age at blood withdrawal. My outcome variable was PE status and variable of PE was not present in the ARCH questionnaire; however, birth certificate provided this information. To find more cases, because we decided to review medical records (MR) of the ARCH study subjects. Case base for my study was obtained by reviewing medical records. I used conditional logistic regression to look for the association between IgGs of three microorganisms and other covariates of interest, and PE status by building three separate conditional logistic regression models.Results: Out of total sample of 73 subjects, 21 were cases. Two (9.5%) of the cases and three (5.8%) of the controls were found positive for anti H. pylori IgGs in their plasma. For CMV, 7 (33.3%) cases and 15 (28.9%) controls had anti CMV IgG in their plasma while thirteen (62%) cases and 25 (48%) of controls were positive for anti C. pneumoniae IgGs in their plasma. At the Univariable analysis, Smoking during pregnancy showed a protective effect for PE. The women who smoked during pregnancy were 40% less likely to have PE than women who did not smoke during pregnancy. Women whose pre-pregnancy BMI (PPBMI) was more than 30 were 8 times more likely to develop PE as compared to the women whose PPBMI was less than 25. Multivariable conditional analysis found that women who were positive for anti H. pylori IgGs in their plasma were 2.4 times more likely to develop PE (mOR: 2.4; 95% CI: 0.2-32.2) than those women whose plasma was negative for these antibodies after controlling for the effect of other variables in the model. Similarly, women with anti CMV IgGs in their plasma were 1.4 times more likely to have PE than women without any evidence of CMV infection (mOR: 1.4; 95% CI: 0.3-5.6) after controlling for the effect of other variables in the model. For C. pneumoniae, the odds of anti C. pneumoniae IgGs among PE cases is 2.3 times (mOR: 2.3; 95% CI: 0.6-9.1) the odds of anti C. pneumoniae IgGs after controlling for the effect of other variables in the model.Conclusions: Past infection, as depicted by anti H. pylori IgG, anti CMV IgG, and anti C. pneumoniae IgG, did not show any association with the development of PE in Lansing, Michigan. No evidence of recent or current infection with CMV as measured by IgM, identified as a risk factor for the development of PE in Lansing, Michigan. To explore this relationship further, similar studies should be carried out in future with a larger sample size especially in populations where prevalence of these infections is high. Future studies should include serology for anti-CagA antibodies for the exploration of the role of H. pylori. Exploration of the infectious agents DNA from placental tissue may support the immunological cause of PE.
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