Seroepidemiology of Toxoplasma, Rubella, Cytomegalovirus and Herpes Simplex Virus -2 in Women with Bad Obstetric History. PART II. Cytomegalovirus and Herpes Simplex Virus Infections

Abstract

Bad obstetric history (BOH) is reported worldwide and is associated with social and psychological impacts. Cytomegalovirus and herpes simplex virus play an important role in the induction of adverse outcomes of pregnancy. Highest CMV IgG prevalence rate was reported for India (91.05%), while the lowest rate was reported for Iran (14.28%). Unfortunately, six studies in Iraq reported a high prevalence of CMV IgM in non-married, pregnant and women with BOH. The range of recent CMV infection in pregnant women with BOH was from 1.4% in Jordan to 60.2% in Iraq. In women with BOH, the highest HSV 2 prevalence (16.8%) was noted in India, while the lowest rate (1.69%) was reported in India also. In Arab countries, among women with BOH, HSV 2 IgG and IgM seroprevalence higher rates were reported for Iraq. This literature review highlights the high bacterial and viral maternal infection rate in the developing world. Urgent, concerted action is required to reduce the burden of these infections. In addition to raising awareness about the severity of the problem of maternal infections in the developing world, data from this review will be beneficial in guiding public health policy, research interests and donor funding towards achieving improvement in health care delivery.

Association between Herpes Simplex virus type 2 (HSV 2) and bad obstetric outcomes

“…Because the infection is common in women of reproductive age it can be contracted and transmitted to the fetus during pregnancy and the newborn [15,19]. Herpes simplex virus is an important cause of neonatal infection, which can lead to death or long-term disabilities.…”

“…In addition, antenatal care services may not have the capacity to routinely screen for maternal infections, especially those that are asymptomatic and those that require serological tests such as PCR and ELISA to diagnose, due to limited resources or expertise. These infrastructural problems are essential contributors to the persistence of high maternal morbidity and mortality in developing countries and need to be overcome in order to accurately characterize the burden of maternal infections in these countries, including Iraq [19]. This literature review highlights the high microbial maternal infection rates in the developing world, including Iraq.…”

“…Urgent, concerted action is required to reduce the burden of these infections. In addition to raising awareness about the severity of the problem of maternal infections in Iraq, data from seroepidemiological research will be beneficial in guiding public health policy, research interests and donor funding towards achieving improvement in health care delivery [19]. The aim of this study was to identify seroprevalence of HSV 2 IgG and IgM in women with bad obstetric history compared to those with normal pregnancy and the association of these markers with socio-demographic variables of Iraqi population in Kirkuk Governorate.…”

“…Furthermore, the studies performed in Arab countries reported a range of 0.5% [21] to 7.6% [22] for HSV2 IgM and 6.5% [21] to 27.1% [23] for HSV2 IgG in pregnant women. The literature review [19] highlights a gap in existing knowledge on the epidemiology and impact of maternal infection, especially on the aetiology of infectious agents that lead to puerperal sepsis and subsequent mortality. Increased surveillance and diagnostic capabilities in healthcare facilities and in the community is needed to identify the aetiological agents responsible for puerperal sepsis and maternal mortality [15].…”

“…Routine TORCH complex screening during pregnancy is not recommended in Iraq and the extent to which it is performed is unknown. Using healthcare database, seroprevalence of TORCH complex was determined among women with bad obstetric history (BOH) [18,19]. Only four studies reported concerning seroprevalence of HSV 2 in Iraqi women with bad obstetric history [14][15][16][17].…”