Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
PLoS Negl Trop Dis. 2020 Mar 13;14(3):e0008103. doi: 10.1371/journal.pntd.0008103. eCollection 2020 Mar.
Toxoplasma gondii (T. gondii) is an intracellular pathogen that can lead to abortion in pregnant women infected with this parasite. Therefore, the present study aimed to estimate the global seroprevalence of anti-T. gondii antibodies in women who had spontaneous abortion based on the results of published articles and evaluate the relationship between seroprevalence of anti-T. gondii antibodies and abortion via a systematical review and meta-analysis.
Different databases were searched in order to gain access to all studies on the seroprevalence of anti- T. gondii antibodies in women who had spontaneous abortion and association between seroprevalence of anti-T. gondii antibodies and abortion published up to April 25th, 2019. Odds ratio (OR) and the pooled rate seroprevalence of T. gondii with a 95% confidence interval (CI) were calculated using the random effects model.
In total, 8 cross-sectional studies conducted on 1275 women who had abortion in present pregnancy, 40 cross-sectional studies performed on 9122 women who had a history of abortion, and 60 articles (involving 35 cross-sectional studies including 4436 women who had spontaneous abortion as case and 10398 as control and 25 case-control studies entailing 4656 cases and 3178 controls) were included for the final analyses. The random-effects estimates of the prevalence of anti-T. gondii IgG antibody in women who had abortion in present pregnancy and women who had a history of abortion were 33% (95% CI: 17%-49%) and 43% (95% CI: 27%-60%), respectively. In addition, the pooled OR for anti-T. gondii IgG antibody in cross-sectional and case-control studies among women who had spontaneous abortion were 1.65 (95% CI: 1.31-2.09) and 2.26 (95% CI: 1.56-3.28), respectively. Also, statistical analysis showed that the pooled OR of the risk of anti-T. gondii IgM antibody 1.39 (95% CI: 0.61-3.15) in cross-sectional and 4.33 (95% CI: 2.42-7.76) in case-control studies.
Based on the results of the current study, T. gondii infection could be considered a potential risk factor for abortion. It is recommended to carry out further and more comprehensive investigations to determine the effect of T. gondii infection on abortion to prevent and control toxoplasmosis among pregnant women around the world.
刚地弓形虫（T. gondii）是一种细胞内寄生虫，可导致感染该寄生虫的孕妇流产。因此，本研究旨在根据已发表的文章评估因自然流产而就诊的女性中抗 T. 弓形虫抗体的全球血清流行率，并通过系统评价和荟萃分析评估抗 T. 弓形虫抗体血清流行率与流产之间的关系。
为了获得有关因自然流产而就诊的女性中抗 T. 弓形虫抗体血清流行率的所有研究以及抗 T. 弓形虫抗体血清流行率与流产之间关系的研究，我们检索了不同的数据库，检索时间截至 2019 年 4 月 25 日。使用随机效应模型计算 T. 弓形虫的优势比（OR）和汇总阳性率及其 95%置信区间（CI）。
总共纳入了 8 项针对本次妊娠中发生自然流产的 1275 名女性的横断面研究、40 项针对有流产史的 9122 名女性的横断面研究，以及 60 篇文章（包括 35 项横断面研究，涉及 4436 名自然流产患者作为病例，10398 名作为对照，25 项病例对照研究，涉及 4656 例病例和 3178 例对照）用于最终分析。本次妊娠中发生自然流产的女性和有流产史的女性抗 T. 弓形虫 IgG 抗体的随机效应估计流行率分别为 33%（95%CI：17%-49%）和 43%（95%CI：27%-60%）。此外，在自然流产的女性中，横断面和病例对照研究的抗 T. 弓形虫 IgG 抗体的汇总 OR 分别为 1.65（95%CI：1.31-2.09）和 2.26（95%CI：1.56-3.28）。此外，统计分析显示，横断面和病例对照研究中抗 T. 弓形虫 IgM 抗体的汇总 OR 分别为 1.39（95%CI：0.61-3.15）和 4.33（95%CI：2.42-7.76）。
根据本研究的结果，T. 弓形虫感染可被视为流产的潜在危险因素。建议进一步开展更全面的研究，以确定 T. 弓形虫感染对流产的影响，从而在全球范围内预防和控制孕妇的弓形体病。
