Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
Eur J Clin Microbiol Infect Dis. 2022 Jan;41(1):45-51. doi: 10.1007/s10096-021-04337-9. Epub 2021 Aug 30.
The aim of the study was to describe the pregnancy outcome of a large cohort of women with toxoplasmosis seroconversion in pregnancy and to investigate the relation between maternal lymphadenopathy and risk of congenital toxoplasmosis (CT). This was a retrospective study involving women with confirmed toxoplasmosis seroconversion in pregnancy between 2001 and 2017. Women were clinically evaluated for lymphadenopathy and classified as follows: lymphadenopathy absent (L-) or lymphadenopathy present (L+). The mothers were treated and followed-up according to local protocol, and neonates were monitored at least for 1 year in order to diagnose CT. A total of 218 women (one twin pregnancy) were included in the analysis. Pregnancy outcome was as follows: 149 (68%) of children not infected, 62 (28.3%) infected, 4 (1.8%) first trimester termination of pregnancy, 2 (0.9%) first trimester miscarriages, and 3 (1.4%) stillbirths (of which one already counted in the infected cohort). 13.8% of women were L+ , and they were nearly three times more likely to have a child with CT compared to L- women (aOR, 2.90; 95%CI, 1.28-6.58). Moreover, the result was still statistically significant when the analysis was restricted to 81 children whose mothers were clinically examined and received treatment within 5 weeks from estimated time of infection. In conclusion, there is a positive association between L+ status in pregnant women, and risk of CT also confirmed when restricting the analysis to women with early diagnosis of seroconversion and treatment. This data could be very useful in counselling pregnant women with toxoplasmosis seroconversion and lead to direct a more specific therapeutic and diagnostic protocol.
本研究旨在描述一组患有妊娠期间弓形虫血清转化的大量女性的妊娠结局，并探讨母体淋巴结病与先天性弓形虫病（CT）风险之间的关系。这是一项回顾性研究，涉及 2001 年至 2017 年间确诊的妊娠期间弓形虫血清转化的女性。对这些女性进行了临床淋巴结病评估，并分为以下两类：无淋巴结病（L-）或有淋巴结病（L+）。根据当地方案对母亲进行治疗和随访，新生儿至少监测 1 年以诊断 CT。共纳入 218 名女性（1 例双胞胎妊娠）进行分析。妊娠结局如下：149 名（68%）儿童未感染，62 名（28.3%）感染，4 名（1.8%）妊娠早期终止，2 名（0.9%）妊娠早期流产，3 名（1.4%）死胎（其中 1 例已计入感染组）。13.8%的女性为 L+，与 L-女性相比，她们的子女患 CT 的可能性几乎高出三倍（优势比，2.90；95%置信区间，1.28-6.58）。此外，当将分析限制在 81 名母亲在感染估计时间后 5 周内进行临床检查和接受治疗的儿童时，该结果仍然具有统计学意义。总之，孕妇 L+状态与 CT 风险之间存在正相关关系，当将分析限制在早期诊断血清转化和治疗的女性时，这一结果仍然具有统计学意义。这些数据在为弓形虫血清转化的孕妇提供咨询方面非常有用，并可能导致制定更具体的治疗和诊断方案。
