Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy.
Int J Gynaecol Obstet. 2024 Sep;166(3):1218-1224. doi: 10.1002/ijgo.15534. Epub 2024 Apr 15.
Public health interventions promoted during the SARS-CoV-2 pandemic to control viral spread have impacted the occurrence of other communicable disease. Yet no studies have focused on perinatal infections with the potential for neonatal sequelae, including cytomegalovirus (CMV) and Toxoplasma gondii (TG). Here we investigate whether incidence rates of maternal primary CMV and TG infection in pregnancy were affected by the implementation of pandemic-related public health measures.
A retrospective study including all pregnant women with confirmed primary CMV or TG infection in pregnancy, managed between 2018 and 2021 at two university centers. The incidence rate was calculated as the number of CMV and TG infections per 100 consultations with a 95% confidence interval (CI). Data were compared between pre-pandemic (2018-2019) and pandemic (2020 and 2021) years. The Newcombe Wilson with Continuity Correction method was employed to compare incidence rates.
The study population included 215 maternal primary CMV and 192 TG infections. Rate of maternal primary CMV infection decreased in 2021 compared with 2018-2019 (4.49% vs 6.40%, attributable risk [AR] 1.92, P = 0.019). By contrast, the rate of TG infection substantially increased in 2020 (6.95% vs 4.61%, AR 2.34, P = 0.006). Close contact with cats was more common among patients with TG infection in 2020 and 2021 than among pre-pandemic TG-infected women (26.3% and 24.4% vs 13.3%, P = 0.013).
Pandemic-related public health interventions and associated behavioral and lifestyle changes exerted a divergent effect on the incidence of primary CMV and TG infection in pregnancy, likely due to modulation of exposure to risk factors for these infections.
为控制病毒传播而在 SARS-CoV-2 大流行期间推广的公共卫生干预措施影响了其他传染病的发生。然而，目前尚无研究关注具有新生儿后遗症风险的围产期感染，包括巨细胞病毒（CMV）和弓形体病（TG）。在这里，我们研究了与大流行相关的公共卫生措施的实施是否影响了妊娠期间母体原发性 CMV 和 TG 感染的发生率。
这是一项回顾性研究，纳入了 2018 年至 2021 年期间在两个大学中心管理的所有妊娠期间确诊为原发性 CMV 或 TG 感染的孕妇。计算发病率为每 100 次就诊的 CMV 和 TG 感染数，并给出 95%置信区间（CI）。将数据与大流行前（2018-2019 年）和大流行期间（2020 年和 2021 年）进行比较。采用 Newcombe Wilson 连续校正法比较发病率。
研究人群包括 215 例母体原发性 CMV 和 192 例 TG 感染。与 2018-2019 年相比，2021 年母体原发性 CMV 感染率下降（4.49%比 6.40%，归因风险 [AR] 1.92，P=0.019）。相比之下，2020 年 TG 感染率显著增加（6.95%比 4.61%，AR 2.34，P=0.006）。与大流行前的 TG 感染孕妇相比，2020 年和 2021 年患有 TG 感染的患者与猫的密切接触更为常见（分别为 26.3%和 24.4%比 13.3%，P=0.013）。
与大流行相关的公共卫生干预措施以及相关的行为和生活方式的改变，对妊娠期间原发性 CMV 和 TG 感染的发生率产生了不同的影响，这可能是由于对这些感染的危险因素的暴露发生了变化。
