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RISK OF PREECLAMPSIA LINKED TO CONTRACEPTIVE METHOD.

The cause of preeclampsia is unknown, but some studies suggest a possible link with paternal factors: preeclampsia seems to be more common in pregnancies with a new partner and with donor insemination. There is also evidence that preeclampsia results from an immunologic process, as well as speculation that sperm or seminal fluid might contain antigens that help prevent this process from occurring.

These investigators performed a case-control study to test the hypothesis that birth-control methods preventing semen from contacting the endometrium (presumably blocking exposure of the maternal immune system to paternal antigens) might increase the subsequent risk of preeclampsia. Using data from a North Carolina hospital, they compared the birth-control methods of 110 primiparous women with preeclampsia and 115 pregnant women without preeclampsia, matched for age, race, and distance from the hospital.

Multivariate analysis supported the hypothesis: condoms, diaphragms, spermicides, and withdrawal increased the risk of preeclampsia 2.4-fold. Estimates of the total number of exposures to sperm and semen for the cases and controls suggested a dose-response relation, with greater exposure providing more protection.

An accompanying editorial notes that these data are consistent with immunologic theories of preeclampsia, and raises expectations that basic science will provide further insights.

— THL

Published in Journal Watch General Medicine December 12, 1989

Citation(s):

Beer AE. Immunology, contraception, and preeclampsia. JAMA 1989 Dec 8 262 3184-3184.

• Medline abstract (Free)

Klonoff Cohen HS et al. An epidemiologic study of contraception and preeclampsia. JAMA 1989 Dec 8 262 3143-3147.

• Medline abstract (Free)