Nowakowska D, Stray-Pedersen B, Spiewak E, Sobala W, Małafiej E, Wilczyński J
Department of Fetal-Maternal Medicine and Gynecology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland.
Clin Microbiol Infect. 2006 Sep;12(9):913-7. doi: 10.1111/j.1469-0691.2006.01513.x.
This study investigated the prevalence of specific Toxoplasma gondii IgG in pregnancy, the incidence of congenital toxoplasmosis and the prevalence trend of T. gondii infection among pregnant Polish women between 1998 and 2003. The study population comprised 4916 women who were admitted to the Polish Mother's Memorial Hospital Research Institute in Łódź. Their sera were tested for specific IgG and IgM antibodies to T. gondii, and the incidence of T. gondii infection was calculated from the increase in prevalence rates of IgG antibodies in various age groups. Specific IgG antibody was found in 41.3% (95% CI 39.9-42.7) of pregnant women, and the prevalence of IgG increased with age. The linear trend was significant (p <0.001), with an annual seroconversion rate of 0.7% (95% CI 0.004-0.010). The risk of primary infection was estimated to be 0.5% for 9 months, i.e., an incidence of 5/1000 pregnancies. Assuming a 30% maternofetal transmission rate, 1.5/1000 neonates were infected in utero. Seroprevalence during the 6-year study period decreased from 45.4% in 1998 to 39.4% in 2003, with a yearly decline in prevalence of 1.0% (p 0.02). The most important contributory factor to this decline was the group of women aged 19-29 years, among whom seroprevalence decreased significantly (p 0.007). Specific IgM was found in 244 (4.9%) women.
本研究调查了1998年至2003年间波兰孕妇中特定弓形虫IgG的流行情况、先天性弓形虫病的发病率以及弓形虫感染的流行趋势。研究人群包括4916名入住罗兹市波兰母亲纪念医院研究所的女性。检测了她们血清中针对弓形虫的特异性IgG和IgM抗体，并根据各年龄组IgG抗体患病率的增加计算弓形虫感染的发病率。41.3%（95%可信区间39.9 - 42.7）的孕妇检测到特异性IgG抗体，且IgG患病率随年龄增加。线性趋势显著（p <0.001），年血清转化率为0.7%（95%可信区间0.004 - 0.010）。估计9个月内初次感染风险为0.5%，即每1000次妊娠中有5例发病。假设母婴传播率为30%，则1.5/1000的新生儿在子宫内感染。在6年研究期间，血清阳性率从1998年的45.4%降至2003年的39.4%，患病率每年下降1.0%（p = 0.02）。导致这种下降的最重要因素是19至29岁的女性群体，其中血清阳性率显著下降（p = 0.007）。244名（4.9%）女性检测到特异性IgM。
