Kheirandish Farnaz, Ezatpour Behrouz, Fallahi S Hirzad, Tarahi Mohammad Javad, Hosseini Pardis, Karimi Rouzbahani Arian, Seyyed Tabaei Seyyed Javad, Akbari Soheila
Razi Herbal Medicines Research Center, Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Fertil Steril. 2019 Oct;13(3):184-189. doi: 10.22074/ijfs.2019.5740. Epub 2019 Jul 14.
is one of the major causes of abortion in pregnant women. Most cases of abortion occur in the acute phase of infection and early pregnancy. The purpose of this study was to investigate the association between spontaneous abortion and seropositive status of toxoplasmosis in women with first-time spontaneous abortion.
This research is a case-control study on 240 serum samples from women experiencing spontaneous abortion for the first time as the case group, and 240 serum samples from women who had a normal delivery with no history of abortion as the control group. The level of anti- IgM and IgG antibodies were assessed in serum samples using ELISA. To separate the acute and chronic infections, all IgM-positive samples in both groups and IgG-positive samples of the case group were examined using IgG avidity.
The IgM antibody was detected in 3.3% (8/240) of the case group and 0.4% (1/240) of the control group, which was a statistically significant difference between the two groups [P=0.019, odds ratio (OR)=10.266]. Of all samples 47.5% and 46.3% of the case and control groups were positive for IgG antibody, respectively. Seven out of 8 (87.5%) IgM-positive serum samples from the case group had low IgG avidity, indicating acute infections, whereas all IgG-positive sera and 1 IgM-positive serum, which was related to the control group, showed a high IgG avidity, indicating chronic infections.
Maternal acute during pregnancy is raised as one of the factors that increase the chance of spontaneous abortion. The necessary health training, especially on the parasite transmission ways to women before marriage, as well as the serological test in women before and during pregnancy is recommended. Polymerase chain reaction (PCR) and IgG avidity assays should be performed in the medical diagnostic laboratories for accurate distinguishing of the initial infection of toxoplasmosis in the pregnant women.
是孕妇流产的主要原因之一。大多数流产病例发生在感染急性期和妊娠早期。本研究的目的是调查首次自然流产妇女中自然流产与弓形虫血清阳性状态之间的关联。
本研究为病例对照研究，以240例首次自然流产妇女的血清样本为病例组，240例无流产史的正常分娩妇女的血清样本为对照组。采用酶联免疫吸附测定法（ELISA）评估血清样本中抗IgM和IgG抗体水平。为区分急性和慢性感染，对两组中所有IgM阳性样本及病例组IgG阳性样本进行IgG亲和力检测。
病例组中3.3%（8/240）检测到IgM抗体，对照组中0.4%（1/240）检测到IgM抗体，两组之间差异有统计学意义[P = 0.019，比值比（OR）= 10.266]。病例组和对照组所有样本中IgG抗体阳性率分别为47.5%和46.3%。病例组8例IgM阳性血清样本中有7例（87.5%）IgG亲和力低，表明为急性感染，而所有IgG阳性血清及对照组1例IgM阳性血清IgG亲和力高，表明为慢性感染。
孕期母体急性感染被认为是增加自然流产几率的因素之一。建议进行必要的健康培训，尤其是婚前对女性进行寄生虫传播途径的培训，以及孕期女性的血清学检测。医学诊断实验室应进行聚合酶链反应（PCR）和IgG亲和力检测，以准确区分孕妇弓形虫的初次感染。
