Q Fever During Pregnancy
Diagnosis, Treatment, and Follow-up
Didier Raoult, MD, PhD;
Florence Fenollar, MD;
Andreas Stein, MD, PhD
Arch Intern Med. 2002;162:701-704.
Background Q fever, caused by Coxiella burnetii, may result
in abortions, premature deliveries, and stillbirths in infected pregnant women.
Objective To evaluate the best treatment strategy for Q fever during pregnancy.
Methods We evaluated the prognosis of 17 pregnant women who developed Q fever
with and without co-trimoxazole (trimethoprim-sulfamethoxazole) treatment.
Results The outcome of the pregnancy was found to depend on the trimester. Abortions
occurred in 7 of 7 insufficiently treated patients infected during the first
trimester vs 1 of 5 patients infected later. Co-trimoxazole given until delivery
protected against abortion (0/4) but not against the development of chronic
infections, and it did not significantly reduce the colonization of the placenta
(2/4 vs 4/4).
Conclusions Our results show that C burnetii infections
cause abortion and that women who develop Q fever while pregnant should be
treated with co-trimoxazole for the duration of pregnancy, specifically when
infected during the first trimester.
From the Unité des Rickettsies, Université de la Méditerranée,
Faculté de Médecine, Marseille, France.
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