Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA.
Int J Infect Dis. 2021 Apr;105:357-373. doi: 10.1016/j.ijid.2021.02.074. Epub 2021 Feb 20.
Vertical transmission of Trypanosoma cruzi infection from mother to infant accounts for a growing proportion of new Chagas disease cases. However, no systematic reviews of risk factors for T. cruzi vertical transmission have been performed.
We performed a systematic review of the literature in PubMed, LILACS, and Embase databases, following PRISMA guidelines. Studies were not excluded based on language, country of origin, or publication date.
Our literature review yielded 27 relevant studies examining a wide variety of risk factors, including maternal age, parasitic load, immunologic factors and vector exposure. Several studies suggested that mothers with higher parasitic loads may have a greater risk of vertical transmission. A meta-analysis of 2 studies found a significantly higher parasitic load among transmitting than non-transmitting mothers with T. cruzi infection. A second meta-analysis of 10 studies demonstrated that maternal age was not significantly associated with vertical transmission risk.
The literature suggests that high maternal parasitic load may be a risk factor for congenital Chagas disease among infants of T. cruzi seropositive mothers. Given the considerable heterogeneity and risk of bias among current literature, additional studies are warranted to assess potential risk factors for vertical transmission of T. cruzi infection.
从母亲到婴儿的克氏锥虫感染垂直传播占新的恰加斯病病例的比例越来越大。然而，目前尚未对克氏锥虫垂直传播的危险因素进行系统评价。
我们根据 PRISMA 指南，在 PubMed、LILACS 和 Embase 数据库中进行了系统的文献回顾。研究不根据语言、来源国或出版日期进行排除。
我们的文献回顾产生了 27 项相关研究，研究了各种危险因素，包括母亲年龄、寄生虫负荷、免疫因素和媒介暴露。一些研究表明，寄生虫负荷较高的母亲垂直传播的风险可能更大。对 2 项研究的荟萃分析发现，感染克氏锥虫的传播母亲的寄生虫负荷明显高于非传播母亲。对 10 项研究的第二次荟萃分析表明，母亲年龄与垂直传播风险无显著相关性。
文献表明，高母体寄生虫负荷可能是 T. cruzi 血清阳性母亲的婴儿先天性恰加斯病的危险因素。鉴于目前文献中存在相当大的异质性和偏倚风险，需要进一步的研究来评估克氏锥虫感染垂直传播的潜在危险因素。
