Low incidence of hypertensive disorders of pregnancy in women treated with spiramycin for toxoplasma infection

Br J Clin Pharmacol. 2006 Mar;61(3):336-40. doi: 10.1111/j.1365-2125.2005.02572.x.

Abstract

Aims: Toxoplasma infection in pregnancy is usually treated with long-term administration of the macrolide spiramycin to prevent fetal malformations. We had empirically observed that treated patients seldom developed pregnancy-induced hypertension (PIH), a common and severe disorder of pregnancy whose aetiology and pathogenesis are still debated. Some clinical and experimental data suggest that infection could play a role in its development.

Methods: To test this hypothesis, we studied a cohort of 417 pregnant women treated with spiramycin because of seroconversion for Toxoplasma gondii and 353 low-risk women who did not take any antibiotic during pregnancy. PIH was defined as blood pressure>140/90 mmHg on two or more occasions, occurring after 20 weeks of gestational age.

Results: Seventeen (5.2%) women in the control group developed PIH compared with two (0.5%) in the case group. The odds of developing the disease were significantly lower in the treated subjects (odds ratio=0.092, 95% confidence interval 0.021, 0.399; P<0.001).

Conclusions: Our results suggest that antibiotic treatment during pregnancy can reduce the incidence of PIH, thus opening new perspectives in its prevention and therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / prevention & control*
  • Pre-Eclampsia / prevention & control
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Spiramycin / therapeutic use*
  • Toxoplasmosis / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Spiramycin