ABSTRACT

BACKGROUND: The association of Chlamydophila pneumoniae infection with essential hypertension is known but its association with hypertension during pregnancy is controversial. Hence, this study aimed to explore the association of C. pneumoniae infection with hypertension during pregnancy. The objectives were to compare the presence of C. pneumoniae DNA in trophoblastic cells of placenta between hypertensive and normotensive pregnant women and to find out the presence of inflammatory marker (HSP-60) and the seropositivity (IgG and IgA) of C. pneumoniae in them.

MATERIALS AND METHODS: The study was conducted at a tertiary-care institute, in South-India between 2018 and 2020. Women with hypertension during pregnancy were study group (75) and normotensive pregnant women were control group (75). IgG and IgA antibodies, HSP-60 against C. pneumoniae were estimated by ELISA from 5 ml of venous blood. C. pneumoniae DNA was extracted from placental tissue after delivery and tested by RT-PCR.

STATISTICAL ANALYSIS: The association between C. pneumoniae DNA, seropositivity and hypertension was determined by student test and univariate regression analysis.

RESULTS: C. pneumoniae DNA was detected in the placenta of 29.3% with hypertension and none in controls and the odds was 6.5 (OR-6.5, CI 95%). HSP-60 was elevated in women with preeclampsia and not in gestational hypertension and controls. IgA was not detected and IgG was positive in 15.2% of women with preeclampsia.

CONCLUSION: There is a significant association between C. pneumoniae infection and hypertension during pregnancy and further studies are required to fulfil the Koch’s postulates to prove or disprove it as a causative agent.

摘要

背景：肺炎衣原体感染与原发性高血压的关联是已知的，但其与妊娠期高血压的关联存在争议。因此，本研究旨在探讨肺炎衣原体感染与妊娠期高血压的关系。目标是比较存在肺炎衣原体DNA在高血压和血压正常孕妇和之间胎盘滋养层细胞，找出炎性标记物的存在（HSP-60）和的血清阳性（IgG和IgA）肺炎衣原体在他们。

材料和方法：该研究于 2018 年至 2020 年在印度南部的一家三级保健机构进行。妊娠期高血压妇女为研究组 (75)，血压正常的孕妇为对照组 (75)。IgG和IgA抗体、针对肺炎衣原体的HSP-60通过ELISA从5ml静脉血估计。从分娩后的胎盘组织中提取肺炎衣原体DNA 并通过 RT-PCR 进行检测。

统计分析：肺炎衣原体DNA、血清阳性和高血压之间的关联是通过学生检验和单变量回归分析确定的。

结果：在 29.3% 的高血压胎盘中检测到肺炎衣原体DNA，在对照组中未检测到肺炎衣原体DNA，几率为 6.5（OR-6.5，CI 95%）。HSP-60 在患有先兆子痫的女性中升高，而在妊娠期高血压和对照组中则没有升高。15.2% 的先兆子痫妇女未检测到 IgA，IgG 阳性。

结论：肺炎衣原体感染与妊娠期高血压之间存在显着关联，需要进一步研究以实现 Koch 假设，以证明或反驳其是致病因素。