Evaluation of the relation of human brucellosis with miscariage

Brucellosis is a zoonotic infection caused by the Brucella spp. The disease mainly affects the bovine genitourinary system and presents with its major complication abortus. In humans, it is known to cause spontaneous abortus, premature delivery and intrauterine exitus, yet limited number of systematic studies are available regarding the subject. This study is carried out in a region endemic for brucellosis and compares the brucellosis serology of pregnant women who procure miscarriage and those who accomplish a full term pregnancy. The study is conducted at the Department of Gynecology and Obstetrics in Gaziantep University Faculty of Medicine between August 2012 and June 2013. 71 patients aged between 18 and 40 and who experienced intrauterine abortus were enrolled in the study, whereas 109 pregnant women accomplishing a full term pregnancy served as the control group. The two groups were congruent in terms of patient age and gestation period. In the abortus group, 10 patients had positive serology for brucellosis (14,1%) as compared to 5 (4,5%) in the control group. Also in this group, women exhibited a statistically significant increase in levels of C-reactive protein, eritrosite sedimentation rate, aspartate aminotransferase and number of abortus and parity (p<0,05). These women were more commonly of the rural area and complaints such as chills and shivering, fever, low back pain were significantly more common. The patient group was further divided into two, as those with a history of bovine contact, low back pain and joint aches and those without; serology positive patients were significantly more relevant in the first group. Pregnant women with abortions revealed higher titers of brucella agglutination, however there was no statistically significant correlation. This study shows an association between brucellosis and abortions which is in consistence with the literature data. Limited number of abortus cases is the major drawback of this study, therefore large prospective studies are imperative to better validate this association between brucellosis and abortions. Nevertheless, especially in endemic areas, pregnant women may be scanned for their brucella serology in order for an early diagnosis and to avoid brucella-related complications.