Faculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China.
NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), 510600, Guangzhou, China.
BMC Public Health. 2023 Feb 16;23(1):351. doi: 10.1186/s12889-023-15238-1.
TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse's migrant status on the TORCH epidemic among women of childbearing age.
Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15-49 years old) in Guangdong Province of China (2014-2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors.
Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88-0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77-1.99), past CMV infection (aOR: 1.26, 1.25-1.28) and RV infection in natural ways (aOR: 1.05, 1.04-1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85-0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05-1.27) and RV infection (aOR: 1.33, 1.31-1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection.
This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse's migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.
TORCH 感染是导致先天性畸形和婴儿死亡的最常见的产前感染，尤其是在发展中国家。移民妇女可能更容易受到 TORCH 感染，但对于移民相关特征与 TORCH 感染风险之间的关系知之甚少。本研究旨在探讨移民身份、移民距离以及配偶的移民身份对育龄妇女 TORCH 流行的影响。
本研究基于中国广东省国家免费孕前健康检查项目（2014-2019 年），分析了中国育龄妇女（15-49 岁）TORCH 感染的代表性数据集（n=2451297）。确定了 TORCH 感染（弓形虫 [TOX]、巨细胞病毒 [CMV] 和风疹病毒 [RV]）的既往和/或近期感染状况。收集了人口统计学和移民相关特征。在调整其他社会人口因素后，我们使用多变量逻辑回归全面评估了移民和本地妇女的 TORCH 感染患病率，并估计了移民相关特征的调整比值比（aOR）。
在所有 2451297 名参与者中，443725 名（18.1%）是移民妇女。与本地妇女相比，移民妇女既往 TOX 感染的风险较低（aOR：0.89，0.88-0.91），提示存在健康移民效应（HME），但近期 TOX 感染（aOR：1.88，1.77-1.99）、既往 CMV 感染（aOR：1.26，1.25-1.28）和自然途径的 RV 感染（aOR：1.05，1.04-1.06）的风险较高。与省内移民相比，省际移民既往 TOX 感染的风险较低（aOR：0.88，0.85-0.91），但近期 TOX 感染（aOR：1.16，1.05-1.27）和 RV 感染（aOR：1.33，1.31-1.36）的风险较高。此外，配偶的移民身份与所有类型的感染风险增加有关。
本研究报告了移民身份和移民距离与 TORCH 感染之间的关联，尽管这些关联的意义和方向因病原体而异。配偶的移民身份进一步放大了所有病原体感染的风险。我们的研究结果表明，中国南方地区需要采取措施预防 CMV 和 RV 感染的传播和新的 TOX 感染，缩小本地移民的健康差距，降低产前感染及其相关不良结局的发生率。
