University of South Florida College of Nursing, Tampa, Fl, USA.
Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, CA 92831, USA.
Eur J Obstet Gynecol Reprod Biol. 2024 Mar;294:28-32. doi: 10.1016/j.ejogrb.2024.01.001. Epub 2024 Jan 5.
Retinal photography was performed in pregnancy and postpartum in pregnant Hispanic women with latent Toxoplasma gondii (TG) infection in order to screen for characteristic retinal lesions or the particular scars found in people with active T. gondii infection. A comparison group of TG negative women was included in the study but they did not have retinal photography.
The goal of the parent study was to assess for adverse pregnancy events and evidence for parasite reactivation in TG positive (TG + ) women, through examination of the eyes for characteristic lesions. Retinal photography, usually at prenatal visits 2 (17 +/- 3.35 weeks) and 3 (26.3+/-1.75) weeks, was done on TG + women. Fifty-six of these women also (43 %) had retinal photography at the postpartum visit. Health and demographic data were obtained at the first prenatal visit for all women.
From the 690 recruited at the first prenatal visit, 128 TG- women and 158 TG + women were enrolled in a prospective study through pregnancy and the postpartum. All TG- women (n = 532) provided data at the first prenatal visit and throughout their pregnancy and birth through the EHR. This allowed comparison of health and outcome data for the TG + compared to a larger number of TG- Hispanic pregnant women.
While there was no evidence of ocular toxoplasmosis during pregnancy, there was a surprisingly large number (42 %) of TG + women with diabetic retinopathy (DR). We also observed that TG + women had a 20 % incidence of gestational diabetes mellitus (GDM) compared to 11.3 % in the TG- women (p = 0.01). At postpartum (mean 5.6 weeks), 23 of 30 women with pregnancy DR showed no DR in the postpartum.
No characteristic T. gondii lesions were discovered. Retinal photography serendipitously revealed DR in these T. gondii positive women. It was also found that latent TG infection was associated with increased incidence of GDM. Hispanic pregnant women's increased risk for latent TG infection, GDM and DR are underappreciated. Retinal photography may need to be considered an innovative approach to screening.
对患有潜伏性弓形体病（TG）的怀孕西班牙裔妇女在孕期和产后进行视网膜摄影，以筛查特征性视网膜病变或患有活动性弓形体病的人发现的特定疤痕。研究中还包括一组 TG 阴性的对照妇女，但她们没有进行视网膜摄影。
母研究的目的是通过检查眼睛是否有特征性病变，评估 TG 阳性（TG + ）妇女的不良妊娠事件和寄生虫再激活的证据。对 TG + 妇女进行视网膜摄影，通常在产前就诊 2 次（17 +/- 3.35 周）和 3 次（26.3+/-1.75 周）。其中 56 名妇女还（43%）在产后就诊时进行了视网膜摄影。所有妇女在第一次产前就诊时都获得了健康和人口统计学数据。
从第一次产前就诊时招募的 690 名妇女中，128 名 TG- 妇女和 158 名 TG + 妇女通过妊娠和产后进入前瞻性研究。所有 TG- 妇女（n=532）在第一次产前就诊时以及整个妊娠和分娩期间都通过 EHR 提供了数据。这使得可以将 TG + 与大量 TG- 西班牙裔孕妇的健康和结局数据进行比较。
虽然在怀孕期间没有发现眼弓形体病的证据，但出乎意料的是，有相当数量（42%）的 TG + 妇女患有糖尿病性视网膜病变（DR）。我们还观察到，TG + 妇女患妊娠期糖尿病（GDM）的发生率为 20%，而 TG- 妇女为 11.3%（p=0.01）。产后（平均 5.6 周），30 名妊娠 DR 妇女中有 23 名在产后无 DR。
未发现特征性弓形体病病变。视网膜摄影偶然发现这些弓形体病阳性妇女患有 DR。还发现潜伏性 TG 感染与 GDM 发生率增加有关。西班牙裔孕妇的潜伏性 TG 感染、GDM 和 DR 风险增加未得到充分认识。视网膜摄影可能需要被视为一种创新性的筛查方法。
