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先天性弓形虫病患儿母亲感染弓形虫的危险因素:对产前管理和筛查的启示

Risk factors for Toxoplasma gondii infection in mothers of infants with congenital toxoplasmosis: Implications for prenatal management and screening.

作者信息

Boyer Kenneth M, Holfels Ellen, Roizen Nancy, Swisher Charles, Mack Douglas, Remington Jack, Withers Shawn, Meier Paul, McLeod Rima

机构信息

Rush University Medical Center, Chicago, Ill, USA.

出版信息

Am J Obstet Gynecol. 2005 Feb;192(2):564-71. doi: 10.1016/j.ajog.2004.07.031.

Abstract

OBJECTIVE

The purpose of this study was to determine whether demographic characteristics, history of exposure to recognized transmission vehicles, or illness that was compatible with acute toxoplasmosis during gestation identified most mothers of infants with congenital toxoplasmosis.

STUDY DESIGN

Mothers of 131 infants and children who were referred to a national study of treatment for congenital toxoplasmosis were characterized demographically and questioned concerning exposure to recognized risk factors or illness.

RESULTS

No broad demographic features identified populations that were at risk. Only 48% of mothers recognized epidemiologic risk factors (direct or indirect exposure to raw/undercooked meat or to cat excrement) or gestational illnesses that were compatible with acute acquired toxoplasmosis during pregnancy.

CONCLUSION

Maternal risk factors or compatible illnesses were recognized in retrospect by fewer than one half of North American mothers of infants with toxoplasmosis. Educational programs might have prevented acquisition of Toxoplasma gondii by those mothers who had clear exposure risks. However, only systematic serologic screening of all pregnant women at prenatal visits or of all newborn infants at birth would prevent or detect a higher proportion of these congenital infections.

摘要

目的

本研究旨在确定人口统计学特征、接触已知传播媒介的病史或孕期与急性弓形虫病相符的疾病,是否能识别出大多数先天性弓形虫病患儿的母亲。

研究设计

对131名被转诊至一项全国性先天性弓形虫病治疗研究的婴幼儿的母亲进行人口统计学特征描述,并询问她们接触已知风险因素或疾病的情况。

结果

没有广泛的人口统计学特征能识别出有风险的人群。只有48%的母亲认识到流行病学风险因素(直接或间接接触生肉/未煮熟的肉或猫粪)或孕期与急性获得性弓形虫病相符的疾病。

结论

北美先天性弓形虫病患儿的母亲中,不到一半能在事后识别出母亲的风险因素或相符的疾病。教育项目可能会预防那些有明确接触风险的母亲感染弓形虫。然而,只有在产前检查时对所有孕妇或在出生时对所有新生儿进行系统的血清学筛查,才能预防或检测出更高比例的这些先天性感染。

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