孕期血清学TORCH检测在与母体相关和与胎儿相关指征中的应用：一项回顾性研究
The Utility of Serologic TORCH Testing During Pregnancy for Maternal-related Versus Fetal-related Indications: A Retrospective Study.
作者信息
Abu Shqara Raneen, Kaufman Maya, Or Shany, Glikman Daniel, Lowenstein Lior, Frank Wolf Maya
机构信息
From the Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
出版信息
Pediatr Infect Dis J. 2025 Mar 1;44(3):257-262. doi: 10.1097/INF.0000000000004591. Epub 2024 Oct 10.
BACKGROUND
Clear guidelines have not been established about the utility of TORCH serology testing in women for whom TORCH infection is suspected according to clinical and laboratory manifestations during pregnancy. We aimed to compare rates of TORCH infections [specifically cytomegalovirus (CMV), Toxoplasma and rubella] in women who underwent TORCH serology testing due to maternal- versus fetal-related indications.
METHODS
This 10-year single-center retrospective study included all the women beyond 24 weeks of gestation who underwent TORCH serology testing due to maternal- or fetal-related indications. Maternal-related indications included fever, gastroenteritis, elevated liver enzymes and thrombocytopenia. Fetal-related indications included intrauterine growth restriction, polyhydramnios and oligohydramnios.
RESULTS
During the study period, 304 women underwent TORCH serology testing due to maternal-related indications and 771 due to fetal-related indications. For the maternal-related compared with the fetal-related indication group, maternal and congenital TORCH infections were more prevalent ( P = 0.015), specifically CMV ( P = 0.036). Eight (2.6%) of the women with maternal-related indications had a primary TORCH infection; 4 of them (50%) had concomitant congenital infections. Six (0.8%) of the women with fetal-related indications had a primary infection; none had a related congenital infection. Among the women with maternal-related indications, higher rates of maternal TORCH infection were found among those with thrombocytopenia (7.1%) and elevated liver enzymes (3.0%). During the study period, maternal-indicated TORCH testing detected 10.8% of neonates born with a confirmed TORCH infection.
CONCLUSIONS
The clinical yield of TORCH serology for nonspecific sonographic fetal features was low. Nonetheless, maternal-related indications should prompt testing for CMV and Toxoplasma infection.
背景
对于孕期根据临床和实验室表现怀疑有TORCH感染的女性，尚未制定关于TORCH血清学检测效用的明确指南。我们旨在比较因母体相关指征与胎儿相关指征而接受TORCH血清学检测的女性中TORCH感染[特别是巨细胞病毒（CMV）、弓形虫和风疹]的发生率。
方法
这项为期10年的单中心回顾性研究纳入了所有妊娠24周后因母体或胎儿相关指征接受TORCH血清学检测的女性。母体相关指征包括发热、肠胃炎、肝酶升高和血小板减少。胎儿相关指征包括宫内生长受限、羊水过多和羊水过少。
结果
在研究期间，304名女性因母体相关指征接受了TORCH血清学检测，771名女性因胎儿相关指征接受了检测。与胎儿相关指征组相比，母体相关指征组中母体和先天性TORCH感染更为普遍（P = 0.015），特别是CMV（P = 0.036）。8名（2.6%）有母体相关指征的女性发生了原发性TORCH感染；其中4名（50%）伴有先天性感染。6名（0.8%）有胎儿相关指征的女性发生了原发性感染；均无相关先天性感染。在有母体相关指征的女性中，血小板减少者（7.1%）和肝酶升高者（3.0%）的母体TORCH感染率更高。在研究期间，因母体指征进行的TORCH检测发现，10.8%的新生儿出生时确诊有TORCH感染。
结论
TORCH血清学检查对非特异性超声胎儿特征的临床检出率较低。尽管如此，母体相关指征应促使对CMV和弓形虫感染进行检测。
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