BACKGROUND
Atherosclerosis, endothelial dysfunction and inflammation are thought to be key pathophysiologic processes in preeclampsia. The basic thesis of this dissertation is that maternal infections may trigger upregulation of proinflammatory cytokines in women with preeclampsia resulting in vascular injury.
OBJECTIVES
We evaluated the evidence for a potential infectious disease etiology for preeclampsia in three papers.
METHODS
For the first paper, we conducted a 1:3 matched case control study. In this study we measured immunoglobulin G (IgG) antibodies to HSV-1, HSV-2, CMV, and EBV in serum samples obtained from 50 cases with preeclampsia and 150 normotensive controls, matched on age, parity and race.
For the second paper, we conducted a comprehensive review of published studies that explored the association between both bacterial and viral infections, and examined the strength of this association.
For the third paper, we investigated the association between self-reported Genital Warts (HPV), Genital Herpes (HSV-2), Chlamydia (C. trachomatis), Gonorrhea (N. gonorrhoeae) infections, sociodemographic, and behavioral risk factors and the risk of preeclampsia in a representative national sample of 10,847 reproductive age women.
RESULTS
We found that seroconversion for HSV 1 /2 or CMV was associated with a five-fold increased risk for developing preeclampsia (OR 5.4, 95% CI 1.0-29.0) after adjusting for education, income, smoking, years of cohabitation, medical insurance, and type of birth control.
Pooling of relevant epidemiologic data, also revealed a two-fold increased risk of preeclampsia associated with bacterial and viral infections (OR 2.1, 95% CI 1.8-2.6).
Additionally, population-based results suggest that Genital Warts, Genital Herpes, and C. trachomatis significantly increased the risk of preeclampsia (OR 3.0, 95% CI 1.0-8.8; OR 7.4, 95% CI 1.4-47.4; OR 5.2, 95% CI 1.3-20.2, respectively), after adjusting for socio-demographic, behavioral, and infection-related risk factors.
PUBLIC HEALTH RELEVANCE
Given the widespread prevalence of these infections, and the potential to prevent infection, our findings have important public health implications in the context of potential preventive strategies and identification of high-risk individuals.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-03172005-152935 |
| Date | 09 June 2005 |
| Creators | Rustveld, Luis Orlando |
| Contributors | Sheryl F. Kelsey, PhD, Rhobert W. Evans, PhD, Russel R. Rycheck, MD, DrPH, Ronald E. LaPorte, PhD, MS (Hyg), Ravi K. Sharma, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-03172005-152935/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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