Vicco Miguel Hernán, Rodeles Luz, Capovilla Gabriela Soledad, Perrig Melina, Choque Ana Gabriela Herrera, Marcipar Iván, Bottasso Oscar, Rodriguez Celeste, Cuña Washington
Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, CC242, 3000, Santa Fe, Argentina.
Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Matern Child Health J. 2016 Oct;20(10):2057-64. doi: 10.1007/s10995-016-2035-8.
Objective The aim of the present research was to evaluate the correlation of vertically transmitted IgG antibodies induced by T. cruzi and newborn early outcome assessment, mainly birth weight and gestational age. Methods We performed a cross-sectional study with 183 pregnant women (64 with asymptomatic Chagas disease) and their newborns. Both were subjected to complete clinical examination. Peripheral parasitemia was assessed in mother and neonates by parasite detection through microscopic examination of the buffycoat from mother's peripheral and cord blood. Antibodies induced by T. cruzi, such as anti-FRA, anti-B13, anti-p2β and anti-T. cruzi were assessed by immunoassay. Birth weight, general condition evaluation by APGAR Score and gestational age by Capurro Score, were determined in newborns. Results The rate of stillbirth background and pregnancy-induced hypertension were higher in patients with Chagas disease (p = 0.01 and p = 0.02, respectively). Parasitemia was detectable in 17 mothers and 4 newborns. The newborns of mothers with detectable parasitemia presented decreased gestational age (p = 0.006) and body weight (p = 0.04). Mostly all the mothers with Chagas disease and all their newborns have positive values of antibodies induced by T. cruzi; however, only anti-p2β showed to be related to the presence of complication during pregnancy (OR 2.35, p = 0.036), and to low birth weight (OR 1.55, p = 0.02). Conclusions Low birth weight and decreased postnatal estimation of maturity were related to detectable parasitemia in the mother. Also, vertical transmission of T. cruzi-induced autoantibodies might have clinical implication in newborns given the negative association between anti-p2β values and weight.
目的 本研究旨在评估克氏锥虫诱导的垂直传播IgG抗体与新生儿早期结局评估的相关性,主要是出生体重和孕周。方法 我们对183名孕妇(64名患有无症状恰加斯病)及其新生儿进行了一项横断面研究。对两者均进行了全面的临床检查。通过显微镜检查母亲外周血和脐带血的血沉棕黄层来检测寄生虫,从而评估母亲和新生儿的外周血寄生虫血症。通过免疫测定法评估克氏锥虫诱导的抗体,如抗FRA、抗B13、抗p2β和抗克氏锥虫抗体。测定新生儿的出生体重、通过阿氏评分进行的一般状况评估以及通过卡普罗评分进行的孕周评估。结果 恰加斯病患者的死产背景率和妊娠高血压发生率较高(分别为p = 0.01和p = 0.02)。在17名母亲和4名新生儿中检测到寄生虫血症。寄生虫血症可检测到的母亲的新生儿孕周降低(p = 0.006)且体重降低(p = 0.04)。几乎所有患有恰加斯病的母亲及其所有新生儿的克氏锥虫诱导抗体值均为阳性;然而,只有抗p2β显示与妊娠期间并发症的存在相关(OR 2.35,p = 0.036),并且与低出生体重相关(OR 1.55,p = 0.02)。结论 低出生体重和出生后成熟度评估降低与母亲可检测到的寄生虫血症有关。此外,鉴于抗p2β值与体重之间的负相关,克氏锥虫诱导的自身抗体的垂直传播可能对新生儿具有临床意义。