Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

Abstract

Background The increased complications to the mother and fetus during or after pregnancy and birth are often caused by a wide array of pathogenic organisms mostly belonging to the TORCH group [toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)]. These agents cause asymptomatic or mild infection in the mother while serious consequences in fetus. The present study was aimed to find significant etiological pathogens in the causation of high risk pregnancy (HRP) in South Indian population. Material and Methods A total of 1, 158 HRP women (2010158 HRP women ( -2013 from Modern Government Maternity Hospital, Hyderabad were considered. Two milliliter of blood was obtained and the serum was analyzed for IgG and IgM antibodies against TORCH agents by ELISA. Results Twenty-five percent of the study group had fetal congenital malformation in the present pregnancy (Group 1; N = 291) while 75 % showed bad obstetric history (BOH) (Group 2; N = 867). Maternal age of B25 years, primi gravida, and consanguinity showed predisposing role for Group 1 while maternal age C30 years and C 3 gravida were contributing risk for Group 2. The seropositvity in 123HRP women for toxoplasma, rubella, CMV, and HSV was 28, 84, 92, and 61 %, respectively for IgG while it was 6, 3, 4, and 3 % for IgG ? IgM. Total seropositvity of toxoplasma, rubella, CMV, and HSV in Group 1 was 29, 97, 97, and 62 % while it was 36, 84, 97, and 65 % in Group 2, respectively. Conclusion Maternal age of B25 years, primi gravida, and consanguinity contributed to fetal congenital malformation in the present pregnancy while maternal age of C30 years and C 3 gravida towards BOH. Toxoplasma is protective while rubella and CMV are the infectious agents for HRP. Among the groups, toxoplasma and rubella conferred a predisposing risk towards Group 2 and Group 1, respectively. Sixty-one percent seropositvity of HSV in relation to bad obstetric outcome is the highest prevalence reported so far in India.

Seroprevalence of Toxoplasma, Rubella, CMV and HSV infection at a teaching hospital: A 7 year study from North India

“…An infected person is usually asymptomatic, but during pregnancy, it can cause pregnancy loss, stillbirth and intrauterine malformations in the foetus. [ 1 8 9 ] The incidence of congenital toxoplasmosis varies from country to country and estimated around 1–2 per 1,000 live births in the UK while 1–10 per 10,000 newborns in Europe and other countries. [ 5 9 ] Previous literature had shown seroprevalence of toxoplasma in different countries between 7.7 and 76.7% as as UK 9.1–17.8%, Norway 10.9%, Sweden 14–25.7%, India 45%, Iran 51.8%, France 71% and Brazil 50–76%.…”

“…[ 3 ] It is transmitted from person to person by tiny droplets in air and mother-to-child through the placenta. [ 1 ] Primary virus infection during pregnancy may lead to miscarriage, foetal death, or an infant with serious birth defects including hearing impairment, cataracts and cardiac defects collectively called congenital rubella syndrome. [ 1 ] The prevalence of Rubella infection in pregnant women from the different country were reported as 87% in the USA, 93.3–94% in Saudi Arabia, 95–96% in Turkey, 98% in Spain.…”

“…[ 1 ] Primary virus infection during pregnancy may lead to miscarriage, foetal death, or an infant with serious birth defects including hearing impairment, cataracts and cardiac defects collectively called congenital rubella syndrome. [ 1 ] The prevalence of Rubella infection in pregnant women from the different country were reported as 87% in the USA, 93.3–94% in Saudi Arabia, 95–96% in Turkey, 98% in Spain. [ 5 11 ] In the present study, rubella was prevalent as 1.14% and infant with 1.96% which is comparatively low as reported in previous studies.…”

“…The TORCH pathogens (toxoplasma, rubella virus, cytomegalovirus [(CMV] and herpes simplex virus [HSV]) generally cause asymptomatic or mild infections in the mother,[ 1 2 ] but may result in a serious sequel and congenital malformations in the foetus or years after birth such as spontaneous abortions, intrauterine foetal death, congenital anomalies, intrauterine growth retardation, prematurity, stillbirth and live born infants with the evidence of disease. [ 1 3 4 ] Due to poor environmental and hygiene conditions, pregnant women may be exposed to a variety of these infections. Infection with TORCH pathogens may lead to significant morbidity and mortality in the health, especially in developing countries.…”

“…Infection with TORCH pathogens may lead to significant morbidity and mortality in the health, especially in developing countries. [ 1 ] It is challenging to diagnose TORCH aetiology clinically, therefore diagnosis is usually established by seroconversion in paired sera or by the presence of specific antibody. [ 5 ] The prevalence of these infections varies with the geographical area.…”