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评估同时检测IgM、IgG亲和力和IgA在孕妇急性弓形虫病诊断中的应用:一项系统评价和荟萃分析研究

Assessment of simultaneous IgM, IgG avidity, and IgA testing in diagnosis of acute toxoplasmosis in pregnant women: a systematic review and meta-analysis study.

作者信息

Tork Mostafa, Sadeghi Mitra, Asgarian-Omran Hossein, Basirpour Bahareh, Ahmadi Somayeh, Ghasemzadeh Fatemeh, Sarvi Shahabeddin, Gholami Shirzad, Hosseini Seyed Abdollah, Daryani Ahmad, Aghayan Sargis A

机构信息

Toxoplasmosis Research Center, Communicable Diseases Institute, Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran.

Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

BMC Pregnancy Childbirth. 2025 May 6;25(1):537. doi: 10.1186/s12884-025-07580-6.

Abstract

BACKGROUNDS

Toxoplasma gondii is a relatively common parasite with a global prevalence that can cause toxoplasmosis. This infection usually does not have clear symptoms, so timely and accurate detection plays a major role in the treatment of this disease. This study reviewed Toxoplasma antibodies dependent serologic tests in pregnancy, assessing their diagnostic effectiveness to guide healthcare providers, particularly obstetricians and gynecologists.

METHODS

In this systematic review and meta-analysis, we utilized four different databases for our search and adhered to the PRISMA guidelines to collect pertinent studies in duration of 2000 to April 2024. After carefully evaluating the inclusion/exclusion criteria list, we ultimately selected 67 qualifying studies for our analysis and subjecting the obtained data to statistical scrutiny.

RESULTS

Data analysis revealed that the pooled seroprevalence of IgM anti-T. gondii among pregnant women tested were 2.1% (95% CI = 1.67 to 3.03). Moreover, the weighted seroprevalence rate estimate of low IgG avidity in IgM-positive pregnant women was 30% (95% CI = 28 to 31) and the seroprevalence of IgA in IgM-positive pregnant women was 43% (95% CI = 18 to 70). Combining the IgG avidity test results with those of IgM and IgA can significantly improve the accuracy of diagnosing recent and past Toxoplasma infections.

CONCLUSIONS

This approach is particularly valuable for pregnant women, as it improves the reliability of serological test outcomes and helps to provide timely treatment and mitigate irreversible complications associated with toxoplasmosis.

摘要

背景

弓形虫是一种相对常见的寄生虫,全球流行率较高,可导致弓形虫病。这种感染通常没有明显症状,因此及时准确的检测对该病的治疗起着重要作用。本研究回顾了孕期弓形虫抗体相关血清学检测,评估其诊断有效性,以指导医疗服务提供者,特别是妇产科医生。

方法

在这项系统评价和荟萃分析中,我们利用四个不同的数据库进行检索,并遵循PRISMA指南收集2000年至2024年4月期间的相关研究。在仔细评估纳入/排除标准清单后,我们最终选择了67项符合条件的研究进行分析,并对获得的数据进行统计审查。

结果

数据分析显示,接受检测的孕妇中抗弓形虫IgM的合并血清阳性率为2.1%(95%CI = 1.67至3.03)。此外,IgM阳性孕妇中低IgG亲和力的加权血清阳性率估计为30%(95%CI = 28至31),IgM阳性孕妇中IgA的血清阳性率为43%(95%CI = 18至70)。将IgG亲和力检测结果与IgM和IgA的结果相结合,可以显著提高诊断近期和既往弓形虫感染的准确性。

结论

这种方法对孕妇特别有价值,因为它提高了血清学检测结果的可靠性,并有助于提供及时治疗,减轻与弓形虫病相关的不可逆并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6246/12054320/7590d5bbe91d/12884_2025_7580_Fig1_HTML.jpg

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