ToRCH “co‐infections” are associated with increased risk of abortion in pregnant women

Abstract

ToRCH infections (toxoplasmosis, rubella, cytomegalovirus and Herpes simplex virus) have long been known to be associated with bad obstetric outcomes. However, little information is available about the impact of ToRCH co-infections on the outcome of pregnancy. Hence, we tested the IgG and IgM antibodies to Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes Simplex Virus among 81 pregnant women with abortion (case group) and 98 pregnant women with normal delivery (control group). In the single-infection model, only CMV-IgM seropositivity was significantly increased in case than control group (25.9% in case and 12.2 % in control, OR = 2.5, P = 0.019). In the co-infection model, 14 patterns were recognized, but two patterns were significantly increased in the case than the control group. Co-infection of T. gondii IgG + CMV IgM was 9.1-fold increased in the case than the control group (8.6% in the case and 1% in control, OR = 9.1; P = 0.024). Also, co-infection of T. gondii IgG + HSV IgG + CMV IgM was 7.7-fold increased in case than the control group (7.4% in case and 1 % in control, OR = 7.7; P = 0.04). Although the OR of other co-infections was higher in the case than the control group, the difference was not statistically significant. These findings indicate that ToRCH co-infections are associated with increased risk of abortion than single infection. Hence, the rates of co-infections should be considered in prenatal screening of ToRCH infections.

Seasonal influence on TORCH infection and analysis of multi‐positive samples with indirect immunofluorescence assay

“…Marawan’s article pointed that TOX‐IgM‐positive tests were associated with seropositivity to HSV1‐IgG and HSV2‐IgM antibodies and that TOX‐seropositive patients were 1.94 and 1.35 times more likely than seronegative patients to have previous exposure to CMV and HSV‐1, respectively, which could be caused by that these infections are all linked to the poor socioeconomic conditions . In the study by Rasti et al, TOX‐IgG + CMV‐IgM and TOX‐IgG + HSV‐IgG + CMV‐IgM were the most frequent TORCH co‐infection patterns in the patients with abortion experience. Interestingly, the apparent TORCH co‐infection rates (201/19 000) by ELISA in Rasti’s report were pretty much comparable to that in our data, suggesting the similarity of the ELISA TORCH IgM screening power.…”

The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

“…Clinical CMV manifestations were assessed either with antenatal ultrasound or postnatal cCMV associated complications. The majority of the studies came from Israel (n = 19), where the primary clinical features included abnormal ultrasound, severe brain dysmorphology (mainly in the first and second trimesters), hearing abnormalities, as well as occult CNS symptoms that are associated with neurologic sequelae, abortion, premature deaths, and congenital malformations [71,74,[78][79][80][81][82][83][84][85][86]. On the other hand, some studies reported asymptomatic cCMV infections [87,88].…”

The Seroprevalence of Toxoplasma, Cytomegalovirus and Rubella Infections in Women with Abortion in Kurdistan Region of Iraq: A Brief Report

“…In the most severe cases of congenital infection, this virus might cause abortion and stillbirth. In milder cases, CMV congenital infection can cause hearing loss, vision loss, microcephaly, and seizure (3,4). The risk of primary CMV infection is around three percent, and 0.5% of live birth babies are born with congenital CMV infection (3,4).…”

“…In milder cases, CMV congenital infection can cause hearing loss, vision loss, microcephaly, and seizure (3,4). The risk of primary CMV infection is around three percent, and 0.5% of live birth babies are born with congenital CMV infection (3,4). Anti-CMV IgM antibody positivity indicates primary infections or reactivation of infection, both of which are associated with congenital abnormalities in pregnancy (5).…”