Risk factors for congenital anomalies in high risk pregnant women: a large study from South India

Background: High Risk Pregnancy [HRP] is a condition where mother or developing fetus or both are at increased risk of complications during or after pregnancy and birth. There are no studies so far which have characterized congenital anomalies [CAs] in HRP women with different previous obstetric histories

Aim: The present study was aimed to determine the prevalence, types and distribution of various CAs and also to find out the exact risk factors for different obstetric histories

Subjects and methods: A total of 3301 HRP women [2011-2014] were enrolled. Diagnosis was made using 3D/4D ultrasound. Serum was analyzed for IgG and IgM against TORCH [Toxoplasma, Rubella, CMV and HSV] agents by ELISA. Eleven percent were pregnant women carrying fetuses with CAs in the present pregnancy, while remaining 89% were with bad obstetric history [BOH] and other medical and obstetric complications

Results: Eleven percent pregnant women were carrying fetuses with CAs in the present pregnancy. The major CAs observed were Central Nervous System [CNS] followed by renal anomalies. Maternal age [625 years, OR =1.42, p= 0.002], paternal age [<30 years, OR =1.51, p< 0.001], consanguinity [OR =1.39, p= 0.012] and primi gravida [OR= 3.40, p<0.001] were identified as risk factors for HRP women with fetal CAs in present pregnancy. Maternal age 625 years and paternal age <30 years conferred around 2-fold risk toward CAs in primi gravid women [p< 0.001] whereas consanguinity was associated with CAs in HRP women with BOH [OR= 1.95, p<0.018]. Toxoplasmosis played a significant role in pregnant women with CAs in present pregnancy with previous normal pregnancies [OR = 4.45, p= 0.009]

Conclusion: High prevalence of CAs was found in HRP women compared to general population. Low parental age contributed toward CAs in primi gravida women while consanguinity was found to be a predisposing factor for CAs in HRP with previous BOH. Toxoplasmosis conferred risk for CAs in HRP women with previous normal pregnancies

Evaluation of interleukin-10 [G-1082A] promoter polymorphism in preeclampsia

Preeclampsia is a pregnancy-specific syndrome that may be life-threatening, especially to the fetus. Several causes have been reported that may have a possible role in the development of the disorder. Interleukin-10 affect maternal intravascular inflammation, as well as endothelial dysfunction. The aim of this study was to investigate the association between IL-10 G-1082A polymorphism and pre-eclampsia. A total of eighty-eight pregnant women with preeclampsia and 100 women with normal pregnancy attending the Gynecological unit of Government Maternity Hospital, Petlaburz, Hyderabad, India, were considered for the study. A standard amplification refractory mutation system [ARMS] PCR was carried out for genotyping IL-10 G-1082A promoter polymorphism in all the participants. Genotypic distribution of the control and patient groups were compared with values predicted by Hardy-Weinberg equilibrium using chi[2] test. Odd ratios [OR] and their respective 95% confidence intervals were used to measure the strength of association between IL-10 gene polymorphism and preeclampsia. The frequencies of IL-10 G-1082A genotypes, GG, GA and AA, were 17.8%, 41.09% and 41.09% in women with preeclampsia and 25%, 28% and 47% in the controls respectively. There was no significant difference in the distribution of genotypes and alleles of IL-10 G-1082A between the two groups [Test power=0.66]. The present study suggests that the IL-10 G-1082A gene promoter polymorphism is not a major genetic regulator in the etiology of preeclampsia