Rehman Farhat, Shah Mohsin, Ali Asif, Ahmad Irshad, Sarwar Muhammad Tahir, Rapisarda Agnese Maria Chiara, Cianci Antonio
Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan.
Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
J Obstet Gynaecol. 2020 Nov;40(8):1106-1110. doi: 10.1080/01443615.2019.1702630. Epub 2020 Feb 4.
In women with a bad obstetric history, certain infections are associated with recurrent foetal loss. One of the common infectious agents is a protozoan parasite, . The aim of this study was to assess unpasteurised milk consumption as a potential risk factor for toxoplasmosis in females with recurrent pregnancy loss from the province of Khyber Pakhtunkhwa, Pakistan. In this study, we recruited a total of 360 females, comprising a study group of 180 females with previous history of recurrent pregnancy loss and a control group of 180 females with no such history. Blood serum from the participants was analysed for IgM antibodies by enzyme linked immunosorbent assay. Among the study group, 23 (12.8%) females were serologically positive for IgM antibodies against , whilst 157 (87.2%) were IgM negative. In the control group, only two (4.8%) females were IgM positive, whilst 178 (95.2%) were IgM negative. Bad pregnancy outcome in the study group and control group was observed to be significantly different ( < .0001). In both of these groups, unpasteurised milk consumption was found as a major risk factor for infection. A routine serological investigation should be carried out in pregnant women to rule out toxoplasmosis and reduce the risk of recurrent pregnancy loss as well as congenital toxoplasmosis in newborns.Impact statement Seropositivity for antibodies ranges from 7% to 51% in different regions of the world. The prevalence rate varies because of differences in climate, culture, food habits, behaviour, personal hygiene and cooking habits of different societies and ethnic groups. Various risk factors have been identified that contribute to a high prevalence rate of the disease, including consumption of raw or poorly cooked meat, physical contact with cats or cat litter, consumption of unwashed raw vegetables and fruits, drinking of contaminated water and milk. We presumed that consuming unpasteurised milk could be a potential risk factor for developing toxoplasmosis in pregnant women. This study demonstrates high seroprevalence of antibodies in females of child bearing age that have consumed unpasteurised milk and is a potential risk factor for developing toxoplasmosis. Our findings suggest that primary preventive measures (personal hygiene, frequent hand washing and consuming pasteurised milk) should be taken by health surveillance authorities to focus on families, especially pregnant women, to educate them about personal hygiene, contact with cattle or using their milk and milk products. The latter is especially important to aware them about the hazards of consuming unpasteurised and contaminated milk.
在有不良产科病史的女性中，某些感染与反复胎儿丢失有关。常见的感染病原体之一是原生动物寄生虫， 。本研究的目的是评估在巴基斯坦开伯尔-普赫图赫瓦省反复妊娠丢失的女性中，饮用未巴氏消毒牛奶作为弓形虫病潜在危险因素的情况。在本研究中，我们共招募了360名女性，其中包括180名有反复妊娠丢失史的女性作为研究组，以及180名无此类病史的女性作为对照组。通过酶联免疫吸附测定法分析参与者血清中的 IgM抗体。在研究组中，23名（12.8%）女性针对 的IgM抗体血清学呈阳性，而157名（87.2%）为IgM阴性。在对照组中，只有两名（4.8%）女性IgM呈阳性，而178名（95.2%）为IgM阴性。研究组和对照组的不良妊娠结局存在显著差异（ < .0001）。在这两组中，饮用未巴氏消毒牛奶被发现是 感染的主要危险因素。应对孕妇进行常规血清学调查，以排除弓形虫病，降低反复妊娠丢失以及新生儿先天性弓形虫病的风险。影响声明在世界不同地区， 抗体的血清阳性率在7%至51%之间。患病率因不同社会和种族群体的气候、文化、饮食习惯、行为、个人卫生和烹饪习惯的差异而有所不同。已确定了多种导致该疾病高患病率的危险因素，包括食用生肉或未煮熟的肉、与猫或猫砂有身体接触、食用未清洗的生蔬菜和水果、饮用受污染的水和牛奶。我们推测饮用未巴氏消毒牛奶可能是孕妇患弓形虫病的潜在危险因素。本研究表明，饮用未巴氏消毒牛奶的育龄女性中 抗体血清阳性率较高，这是患弓形虫病的潜在危险因素。我们的研究结果表明，卫生监督部门应采取一级预防措施（个人卫生、勤洗手以及饮用巴氏消毒牛奶），重点关注家庭，尤其是孕妇，对她们进行个人卫生、与牛接触或使用其牛奶及奶制品方面的教育。后者对于让她们意识到饮用未巴氏消毒和受污染牛奶的危害尤为重要。
