Antibodies against Coxiella burnetii and pregnancy outcome during the 2007-2008 Q fever outbreaks in the Netherlands

Abstract

BackgroundQ fever has become a major public health problem in the Netherlands. Infection with Coxiella burnetii (Q fever) during pregnancy has resulted in adverse pregnancy outcome in the majority of reported cases. Therefore, we aimed to quantify this risk by examining the earliest periods corresponding to the epidemic in the Netherlands.MethodsSerum samples that had been collected from the area of highest incidence by an existing national prenatal screening programme and data from the Netherlands Perinatal Registry (PRN) on diagnosis and outcome were used. We performed indirect immunofluorescence assay to detect the presence of IgM and IgG antibodies against C. burnetii in the samples. The serological results were analyzed to determine statistical association with recorded pregnancy outcome.ResultsEvaluation of serological results for 1174 women in the PRN indicated that the presence of IgM and IgG antibodies against phase II of C. burnetii was not significantly associated with preterm delivery, low birth weight, or several other outcome measures.ConclusionThe present population-based study showed no evidence of adverse pregnancy outcome among women who had antibodies to C. burnetii during early pregnancy.

Recent advances in the study of Q fever epidemiology, diagnosis and management

“…33,34 A recently published study in Denmark 35 and a study that we published recently collecting all the data available in the literature in a meta-analysis 36 confirm that Q fever occurring during pregnancy is associated with a risk of miscarriage. The risk of miscarriage is highest in the first trimester, with a risk of fetal growth retardation, fetal malformations and prematurity occurring later.…”

Investigation of Coxiella burnetii Prevalence in Women Who Had Miscarriage and Their Spouses by Serological and Molecular Methods

“…Abortus ve intrauterin gelişme geriliği gibi obstetrik komplikasyonların, hastalı-ğı ilk trimestırda geçirenlerde daha yüksek olduğu ve gebelik süresince trimetoprim-sül-fametoksazol tedavisi alan olgularda düşük riskinin azaldığı vurgulanmaktadır 7 . C.burnetii'nin doğumsal yan etkilerinin mekanizması tam olarak anlaşılamamıştır; ancak plasenta enfeksiyonu, immünolojik mekanizmalarla gerçekleşen plasental yetmezlik, fetüsün direkt olarak etkilenmesi bu olayda rol oynayabileceği belirtilen faktörlerdir 20,21 . Çalışma-mızda C.burnetii IgG pozitifliği düşük yapmış kadınlarda (%27.8), normal doğum yapmış kadınlara (%9.1) oranla daha yüksek bulunmuş, ancak bu fark istatistiksel olarak anlamlı bulunmamıştır (p> 0.05).…”

“…Salgın durumlarında tüm gebelerin C.burnetii için serolojik taramadan geçirilmeleri ve pozitif bulunursa uzun süreli antibiyotik tedavisi almaları önerilmektedir 7,21 . Sonuç olarak, gerek sporadik gerekse epidemik C.burnetii enfeksiyonlarında gebe kadınlardaki riskin göz önünde bulundurulması; gebelik sırasında ortaya çıkan nedeni bilinmeyen ateş veya açıklanamayan düşük olgularının Q ateşi yönünden araştırılmasının uygun olacağı düşünülmüştür.…”

A preliminary report of relationship between abortion and Q fever in Central Black Sea Region Turkish woman

“…van der Hoek et al [19] in their study, examined serum samples from 1174 pregnancies with a gestational age of 16 weeks or more from women living in the high-risk area and found no association between positive Q fever serology and adverse pregnancy outcome.…”