Infectious diseases in pregnancy as a risk factor of development the heavy preeclampsia
The aim of the research. To study the association between the risk of severe preeclampsia developing and acute infectious processes in mothers-carriers of pre-eclampsia predictor genes AGTR1-1166CC and NOS3-894TT. Material and methods. A retrospective case-control study included 50 women with severe preeclampsia and 50 women in the comparison group. All patients were carriers of genetic polymorphisms AGTR1-1166CC and NOS3-894TT, which are predictors of preeclampsia. The average age of pregnant women ranged from 20 to 35 years old. All women had a single-stage pregnancy, had no previous hypertension, kidney disease, cardiovascular, autoimmune, metabolic diseases, pre-eclampsia in the anamnesis. Genetic polymorphisms were studied by polymerase chain reaction with the detection of the amplification product in real time. Statistical analysis included the calculation of χ2, the odds ratio with its 95% of confidence interval (95% CI). Results. The risk of severe preeclampsia was significantly higher in women with asymptomatic bacteriuria (OR = 17.0, 95% CI 4.66-61.81), acute gestational pyelonephritis (OR = 5.4, 95% CI 1.69-10.54 ), acute nonspecific bacterial vaginitis (OR = 6.7, 95% CI 1.90-11.02), acute candidal vulvovaginitis (OR = 4.3, 95% CI 1.45-9.99). Acute cytomegalovirus infection, toxoplasmosis, bacterial vaginosis were registered only in a group of patients with preeclampsia. Systemic infectious diseases increase the probability of developing the severe preeclampsia in a greater extent (OR = 49.6, 95% CI 13.05-188.64) than local infectious processes (OR = 4.5, 95% CI 1.49-6, 71). The conclusion. Our data confirm that acute infection in a mother increases the risk of developing pre-eclampsia more significantly than a genetic predisposition, associated with polymorphisms of candidate genes of pre-eclampsia AGTR1-1166CC and NOS3-894TT. Thus, infectious diseases during pregnancy can be considered as an epigenetic risk factor for the development of severe preeclampsia. Further research is needed to find out the mechanisms of this association.