Rasti Sima, Ghasemi Fatemeh Sadat, Abdoli Amir, Piroozmand Ahmad, Mousavi Seyed Gholam Abbas, Fakhrie-Kashan Zohreh
Department of Parasitology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran.
Congenit Anom (Kyoto). 2016 Mar;56(2):73-8. doi: 10.1111/cga.12138.
ToRCH infections (toxoplasmosis, rubella, cytomegalovirus and Herpes simplex virus) have long been known to be associated with bad obstetric outcomes. However, little information is available about the impact of ToRCH co-infections on the outcome of pregnancy. Hence, we tested the IgG and IgM antibodies to Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes Simplex Virus among 81 pregnant women with abortion (case group) and 98 pregnant women with normal delivery (control group). In the single-infection model, only CMV-IgM seropositivity was significantly increased in case than control group (25.9% in case and 12.2 % in control, OR = 2.5, P = 0.019). In the co-infection model, 14 patterns were recognized, but two patterns were significantly increased in the case than the control group. Co-infection of T. gondii IgG + CMV IgM was 9.1-fold increased in the case than the control group (8.6% in the case and 1% in control, OR = 9.1; P = 0.024). Also, co-infection of T. gondii IgG + HSV IgG + CMV IgM was 7.7-fold increased in case than the control group (7.4% in case and 1 % in control, OR = 7.7; P = 0.04). Although the OR of other co-infections was higher in the case than the control group, the difference was not statistically significant. These findings indicate that ToRCH co-infections are associated with increased risk of abortion than single infection. Hence, the rates of co-infections should be considered in prenatal screening of ToRCH infections.
已知弓形虫、风疹、巨细胞病毒和单纯疱疹病毒（ToRCH）感染长期以来与不良产科结局相关。然而，关于ToRCH混合感染对妊娠结局的影响，目前所知甚少。因此，我们检测了81例流产孕妇（病例组）和98例正常分娩孕妇（对照组）的弓形虫、风疹、巨细胞病毒和单纯疱疹病毒的IgG和IgM抗体。在单一感染模型中，仅病例组的巨细胞病毒IgM血清阳性率显著高于对照组（病例组为25.9%，对照组为12.2%，OR = 2.5，P = 0.019）。在混合感染模型中，识别出14种模式，但其中两种模式在病例组中的比例显著高于对照组。弓形虫IgG和巨细胞病毒IgM混合感染在病例组中的发生率比对照组高9.1倍（病例组为8.6%，对照组为1%，OR = 9.1；P = 0.024）。此外，弓形虫IgG、单纯疱疹病毒IgG和巨细胞病毒IgM混合感染在病例组中的发生率比对照组高7.7倍（病例组为7.4%，对照组为1%，OR = 7.7；P = 0.04）。尽管其他混合感染的OR值在病例组中高于对照组，但差异无统计学意义。这些发现表明，与单一感染相比，ToRCH混合感染与流产风险增加相关。因此，在ToRCH感染的产前筛查中应考虑混合感染率。
