Capretti Maria Grazia, De Angelis Morena, Tridapalli Elisabetta, Orlandi Azzurra, Marangoni Antonella, Moroni Alessandra, Guerra Brunella, Arcuri Santo, Marsico Concetta, Faldella Giacomo
From the *Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology; †Department of Specialised, Experimental and Diagnostic Medicine, Microbiology; and ‡Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Gynaecology and Obstetrics, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Pediatr Infect Dis J. 2014 Jan;33(1):5-10. doi: 10.1097/INF.0000000000000006.
The effectiveness of Toxoplasma gondii (Tg) screening during pregnancy in areas with a low prevalence of the infection is debated. We investigate the Tg serological status, the rate of primary infection in a cohort of pregnant women and the rate of congenital toxoplasmosis among their infants during a 3-year period in an urban area with low Tg prevalence.
Demographic and Tg serological data for all pregnant women delivering from January 2009 to December 2011 were collected. All pregnant women with primary Tg infection during pregnancy and their infants were included in the study.
In early pregnancy, 10,347 women underwent prenatal screening and 2308 (22.3%) had anti-Tg. The seroprevalence among non-native women was significantly higher than that among native women [32.8% vs. 19.1%, relative risk: 1.71, P < 0.001]. The incidence rate of primary Tg infection during pregnancy was 0.77%. Immigrant women were more likely to be infected during pregnancy than Italian women (relative risk: 4.88, P < 0.001). Tg infection was more frequent in women coming from Africa, Asia, Eastern Europe and South America. The CT incidence rate was 0.06%. All congenitally infected infants were born to immigrant mothers.
Tg infection during pregnancy and congenital disease are more frequent in non-native mothers and their infants. Measures to prevent Tg exposition must be carefully explained to pregnant women, with a focus on specific habits in non-native women. Prenatal screening is still effective to select women for prenatal therapy aiming to decrease vertical transmission and to identify foetuses/newborns with congenital disease that could benefit from pre/postnatal antiparasitic therapy.
在弓形虫（Tg）感染率较低的地区，孕期进行弓形虫筛查的有效性存在争议。我们调查了在一个弓形虫感染率较低的城市地区，一组孕妇的弓形虫血清学状态、原发性感染率以及她们的婴儿中先天性弓形虫病的发生率，为期3年。
收集了2009年1月至2011年12月期间所有分娩孕妇的人口统计学和弓形虫血清学数据。所有孕期原发性弓形虫感染的孕妇及其婴儿均纳入研究。
孕早期，10347名妇女接受了产前筛查，2308名（22.3%）有抗Tg抗体。非本地妇女的血清阳性率显著高于本地妇女[32.8%对19.1%，相对风险：1.71，P<0.001]。孕期原发性弓形虫感染的发生率为0.77%。移民妇女在孕期比意大利妇女更易感染（相对风险：4.88，P<0.001）。来自非洲、亚洲、东欧和南美洲的妇女弓形虫感染更频繁。先天性弓形虫病的发生率为0.06%。所有先天性感染婴儿均为移民母亲所生。
非本地母亲及其婴儿孕期弓形虫感染和先天性疾病更为常见。必须向孕妇仔细解释预防弓形虫暴露的措施，重点关注非本地妇女的特定习惯。产前筛查对于选择接受产前治疗以减少垂直传播的妇女以及识别可能受益于产前/产后抗寄生虫治疗的先天性疾病胎儿/新生儿仍然有效。
