Prevalence of Torch Infections and Its Associated Poor Outcome in High-Risk Pregnant Women of Central India: Time to Think for Prevention Strategies

Manjunathachar, H V; Singh, Kehar; Chouksey, Vivek Kumar; Kumar, Ravindra; Sharma, Rimple; Barde, Pradip V

doi:10.4103/ijmm.ijmm_20_136

Cited by 24 publications

(22 citation statements)

References 27 publications

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“…Primary infections caused by ToRCH pathogens are the major cause of BOH, and this is well corroborated in published studies both locally [2,19,23] and elsewhere [1,5,22]. This study also observed a higher seroprevalence of ToRCH infections in pregnant women with BOH.…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, a study from north India reported the presence of anti-RV antibodies in 82.6% of cases post-vaccination [ 18 ]. Many other studies reported a very high prevalence of rubella-specific-IgG in pregnant women [ 2 , 4 , 19 - 22 ]. Although some authors question the utility of routine screening of RV in pregnancy [ 23 ], it may be instrumental in finding the immunologically naïve (seronegative) pregnant women who are susceptible to RV infection and advising them for preventive measures and vaccination (post pregnancy) for safety in a future pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Seroprevalence and Determinants of ToRCH Pathogens in Pregnant Women in the Sub-Himalayan Region

Deka¹,

Kalita²,

Paul³

et al. 2022

Cureus

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IntroductionToxoplasma gondii (TG), rubella virus (RV), cytomegalovirus (CMV), and herpes simplex virus type 1 and 2 (HSV 1 and 2) cause mild maternal morbidity but have serious fetal consequences. The prevalence of these infections varies widely by country and population subgroup, and the paucity of data from the hilly state of Uttarakhand prompted us to undertake this study on their seroprevalence and association with potential risk factors. MethodsSerum samples received from pregnant women attending the antenatal clinic of All India Institute of Medical Sciences, Rishikesh, between January 2016 to December 2019 were tested for TG-, RV-, CMV, and HSV-specific IgM and IgG by capture enzyme-linked immunoassay (ELISA). The data were then analyzed to determine the seroprevalence of the major ToRCH infections (toxoplasmosis, other (syphilis, varicellazoster, parvovirus B19), rubella, cytomegalovirus, and herpes), and Fisher's exact test was applied to check association with potential risk factors. ResultsOut of 165 pregnant women who were screened for the four major ToRCH pathogens, overall seroprevalence was 41.2% for TG (IgM=13.3%; IgG=38.2%), 80.0% for RV (IgM=3.0%; IgG=80.0%), 61.8% for CMV (IgM=1.8%; IgG=61.8%), and 42.4% for HSV (IgM=4.3%; IgG=40.6). TG was significantly associated with increasing maternal age (p-value=0.007). The seropositivity of RV was maximum in the drier and windy months of January-March (p-value=0.004), while that of TG in the warmer months of April-June (p-value=0.03). HSV prevalence was comparatively more common in Muslim women (p-value=0.05). Women presenting with bad obstetric history (BOH) and multiparous women were at higher risk for TG-RV-HSV and TG-RV-CMV, respectively. ConclusionConsidering the high prevalence and risk of ToRCH infections in this region, we suggest disease-specific screening based on maternal history. Recognition of the burden of ToRCH infections in pregnant women is vital in clinicians' decisions and implementing control measures.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Seroprevalence and Determinants of ToRCH Pathogens in Pregnant Women in the Sub-Himalayan Region

Deka¹,

Kalita²,

Paul³

et al. 2022

Cureus

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“…In addition, circulatory DHEA‐S levels are higher and circulatory cortisol/DHEA‐S ratios are lower among women with stillbirth outcome, compared with women with NBO. These associations with ABO or stillbirth outcome maintained significant odds even after adjusting for potential confounders; pregnant women's TORCH infection status, age, parity, and socioeconomic factors 15–17 …”

Section: Discussionmentioning

confidence: 95%

Comparative profiling of prenatal cortisol and DHEA‐S among pregnant women with poor birth outcome and pregnant women with normal birth outcome

Sundararajan

Vora

Saiyed

et al. 2021

Clinical Endocrinology

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Context Cortisol and dehydroepiandrosterone‐sulfate (DHEA‐S) are indispensable hormones for normal pregnancy. It is unclear if these hormones, specifically DHEA‐S can offer value for predicting poor birth outcome. Objective To compare prenatal cortisol and DHEA‐S levels among pregnant women with normal or poor birth outcome. Methods Plasma and saliva were collected prospectively from women in second‐third trimester of pregnancy. Women with normal birth outcome (NBO) (n = 501) included live birth, no pregnancy complications and ≥2.5 kg infant birth weight. Women with poor birth outcome included adverse birth outcome (ABO) (n = 50) or low birth weight outcome (LBW) (n = 147). Enzyme‐linked immunosorbent assay was performed to measure hormone concentrations in plasma and saliva. Results Circulatory‐DHEA‐S levels in pregnant women with ABO were higher than women with NBO (p = .043). Among ABO, only stillbirth cases demonstrated significant increase in circulatory‐DHEA‐S levels (p = .006). Circulatory and salivary cortisol/DHEA‐S ratio was lower among women with stillbirth (p = .004) and ABO outcome (p = .043) respectively compared with women with NBO. Consistently, increased odds of ABO were observed in pregnant women with highest circulatory‐DHEA‐S levels (odds ratio quartile score 1 vs. 4, 2.79, p = .027) and lowest salivary cortisol/DHEA‐S ratio (score 4 vs. 2, 2.83, p = .025). Increased odds of stillbirth outcome were observed in pregnant women with highest circulatory‐DHEA‐S levels (odds ratio quartile score 1 vs. 4, 8.47, p = .046) and lowest circulatory cortisol/DHEA‐S ratio (score 4 vs. 1, 4.803, p = .048). Associations remained significant after adjusting for confounders. Women with LBW did not demonstrate significant changes in cortisol or DHEA‐S levels. Conclusion Prenatal measurement of DHEA‐S or cortisol/DHEA‐S ratio may offer significant value for predicting adverse birth, specifically stillbirth outcome.

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“…Feeding interventions must be considered as a strategy to get an optimal nutritional status in pregnancies with viral infections to avoid problems related to fetal growth. Some authors claim the need to develop nutritional strategies in common (i.e., TORCH) infections known to present with fetal growth deficits [ [147] , [148] , [149] ]. Moreover, malnutrition can confer a greater predisposition to viral infections during pregnancy, including HEV [ 150 ] or SARS-CoV-2 [ 151 ].…”

Section: Feeding Interventions (Nutrient Supplements) To Improve Fetal Growth During Viral Infectionsmentioning

confidence: 99%

Impact of maternal nutrition in viral infections during pregnancy

Mate

Reyes-Goya

Santana-Garrido

et al. 2021

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

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Other than being a physiological process, pregnancy is a condition characterized by major adaptations of maternal endocrine and metabolic homeostasis that are necessary to accommodate the fetoplacental unit. Unfortunately, all these systemic, cellular, and molecular changes in maternal physiology also make the mother and the fetus more prone to adverse outcomes, including numerous alterations arising from viral infections. Common infections during pregnancy that have long been recognized as congenitally and perinatally transmissible to newborns include toxoplasmosis, rubella, cytomegalovirus, and herpes simplex viruses (originally coined as ToRCH infections). In addition, enterovirus, parvovirus B19, hepatitis virus, varicella-zoster virus, human immunodeficiency virus, Zika and Dengue virus, and, more recently, coronavirus infections including Middle Eastern respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) infections (especially the novel SARS-CoV-2 responsible for the ongoing COVID-19 pandemic), constitute relevant targets for current research on maternal-fetal interactions in viral infections during pregnancy. Appropriate maternal education from preconception to the early postnatal period is crucial to promote healthy pregnancies in general and to prevent and/or reduce the impact of viral infections in particular. Specifically, an adequate lifestyle based on proper nutrition plans and feeding interventions, whenever possible, might be crucial to reduce the risk of virus-related gestational diseases and accompanying complications in later life. Here we aim to provide an overview of the emerging literature addressing the impact of nutrition in the context of potentially harmful viral infections during pregnancy.

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Prevalence of Torch Infections and Its Associated Poor Outcome in High-Risk Pregnant Women of Central India: Time to Think for Prevention Strategies

Cited by 24 publications

References 27 publications

Seroprevalence and Determinants of ToRCH Pathogens in Pregnant Women in the Sub-Himalayan Region

Seroprevalence and Determinants of ToRCH Pathogens in Pregnant Women in the Sub-Himalayan Region

Comparative profiling of prenatal cortisol and DHEA‐S among pregnant women with poor birth outcome and pregnant women with normal birth outcome

Impact of maternal nutrition in viral infections during pregnancy

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