Risk of pregnancy-related hypertension within five years of exposure to bacteria-contaminated drinking water

Abstract

Exposure to Escherichia coli O157:H7 may result in subclinical kidney injury manifesting as hypertension during pregnancy. We evaluated the risk of pregnancy-related hypertension (PRH) among previously healthy females from the Walkerton Health Study, Canada (2002-6), who conceived within five years of exposure to bacteria-contaminated drinking water. Ontario Ministry of Health Antenatal forms were used to determine outcomes and risk factors. PRH was defined as any systolic or diastolic blood pressure (BP) > or =140 mm Hg and > or =90 mm Hg, respectively. Chronic and gestational hypertension were defined, respectively, as elevated BP observed prior to or at > or =20 weeks gestation. Risk of PRH was evaluated using a modified Poisson regression model that controlled for known risk factors. Of 148 eligible pregnancies, antenatal audits with blood pressure data were available for 135. PRH was detected in 20.7% pregnancies, of which 6.7% were chronic hypertension and 14.1% gestational hypertension. Although nonsignificant, we observed a consistent trend toward higher rates of PRH and mean arterial pressure, particularly prior to 20 weeks gestation, among women who reported symptomatic gastroenteritis compared to asymptomatic women. BP should be monitored closely in women after exposure to contaminated water.

Lactobacillus gasseriK7 modulates the blood cell transcriptome of conventional mice infected withEscherichia coliO157:H7

“…) and as eventual clinical consequences may take several years to develop (Moist et al . ). During an outbreak in Canada, 31% (19/62) of exposed kindergarten children were asymptomatic and 53% (10/19) of these asymptomatic children were carriers of E. coli O157:H7 (Duncan et al .…”

“…The moderate effects of E. coli O157:H7 treatment on the results of haematological analyses are in line with the lack of identification of clinical pathologies in this group of mice and are suggestive of a subclinical infection. Asymptomatic E. coli O157:H7 infections in humans are occasionally identified in outbreaks, but an estimation of their occurrence is difficult to estimate, as faecal samples from asymptomatic persons are only rarely sampled (Ryan et al 1986) and as eventual clinical consequences may take several years to develop (Moist et al 2009). During an outbreak in Canada, 31% (19/62) of exposed kindergarten children were asymptomatic and 53% (10/ 19) of these asymptomatic children were carriers of E. coli O157:H7 (Duncan et al 1987).…”

The Duration of Gastrointestinal and Joint Symptoms after a Large Waterborne Outbreak of Gastroenteritis in Finland in 2007 – A Questionnaire-Based 15-Month Follow-Up Study

“…The most intensively studied waterborne outbreak is the Walkerton epidemic in Ontario, Canada. According to the Walkerton Health Study, increased risk of reactive arthritis, irritable bowel syndrome, pregnancy-related hypertension, hypertension, kidney disease, and even cardiovascular events has been observed after the epidemic [5] , [6] , [7] , [8] , [9] , [10] .…”

Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework

“…For example, infection with Escherichia coli has been associated with pregnancy-related hypertension 5 years after infection (Moist et al . 2009 ). Many WASH-related hazards have intergenerational effects; either because contaminants or infectious agents pass through the placenta and affect the foetus, or because they have systemic effects on the mother, such as fever, an altered immune response including inflammation, low weight gain, absorption into bone or anaemia.…”