Romand Stéphane, Chosson Muriel, Franck Jacqueline, Wallon Martine, Kieffer François, Kaiser Karine, Dumon Henri, Peyron François, Thulliez Philippe, Picot Stéphane
Laboratoire de la Toxoplasmose, Institut de Puériculture, Paris, France.
Am J Obstet Gynecol. 2004 Mar;190(3):797-802. doi: 10.1016/j.ajog.2003.09.039.
Our purpose was to evaluate Toxoplasma gondii concentration in amniotic fluid (AF) samples as a prognostic marker of congenital toxoplasmosis.
A retrospective study was carried out in 88 consecutive AF samples from 86 pregnant women, which were found positive by prospective polymerase chain reaction (PCR) testing. Parasite AF concentrations were estimated by real-time quantitative PCR and analyzed in relation to the clinical outcome of infected fetuses during pregnancy and at birth, taking into account the gestational age at maternal infection.
A significant negative linear regression was observed between gestational age at maternal infection and T gondii DNA loads in AF. After adjusting for time at maternal seroconversion by multivariate analysis, higher parasite concentrations were significantly associated with a severe outcome of congenital infection (odds ratio [OR]=15.38/log (parasites/mL AF) [95% CI=2.45-97.7]).
PCR quantification of T gondii in AF can be highly contributive for early prognosis of congenital toxoplasmosis. Maternal infections acquired before 20 weeks with a parasite load greater than 100/mL of AF have the highest risk of severe fetal outcome.
我们的目的是评估羊水（AF）样本中弓形虫的浓度，作为先天性弓形虫病的预后标志物。
对86名孕妇的88份连续羊水样本进行了回顾性研究，这些样本通过前瞻性聚合酶链反应（PCR）检测呈阳性。通过实时定量PCR估计羊水中的寄生虫浓度，并结合感染胎儿在孕期和出生时的临床结局进行分析，同时考虑母亲感染时的孕周。
观察到母亲感染时的孕周与羊水中弓形虫DNA载量之间存在显著的负线性回归。通过多变量分析调整母亲血清转换时间后，较高的寄生虫浓度与先天性感染的严重结局显著相关（优势比[OR]=15.38/log（寄生虫/毫升羊水）[95%可信区间=2.45-97.7]）。
羊水弓形虫的PCR定量对先天性弓形虫病的早期预后有很大贡献。母亲在20周前感染且寄生虫载量大于100/毫升羊水时，胎儿出现严重结局的风险最高。
