Maternal rubella immunity status and pre-eclampsia.

PROBLEM: To determine if maternal immune maladaptation associated with pre-eclampsia is reflected in the rubella immunity status.

METHOD OF STUDY: Incidence of pre-eclampsia was compared between rubella non-immune and immune gravidae carrying a singleton pregnancy beyond 24 weeks, taking into account maternal characteristics and reported risk factors for pre-eclampsia.

RESULTS: The 9870 (10.4%) rubella non-immune gravidae among the 95 024 in the cohort exhibited no difference in incidence of underlying medical disorders, but they were slightly but significantly older, shorter, heavier, and had more pre-eclampsia (OR 1.24, 95% CI 1.05-1.47) despite having fewer nulliparas. Regression analysis confirmed an overall association between rubella non-immunity with pre-eclampsia (aOR 1.27, 95% CI 1.06-1.54), which was related to multiparas (aOR 1.42, 95% CI 1.05-1.91) and carrying a male fetus (aOR 1.37, 95% CI 1.06-1.78).

CONCLUSION: The association between rubella non-immunity and pre-eclampsia reflects immune maladaptation in multiparas and toward a male fetus.