The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: a population-based study in southern China

Abstract

Background TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse’s migrant status on the TORCH epidemic among women of childbearing age. Methods Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15–49 years old) in Guangdong Province of China (2014–2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors. Results Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88–0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77–1.99), past CMV infection (aOR: 1.26, 1.25–1.28) and RV infection in natural ways (aOR: 1.05, 1.04–1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85–0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05–1.27) and RV infection (aOR: 1.33, 1.31–1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection. Conclusion This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse’s migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.

Serum antibodies against ToRCH agents in pregnant women presenting at a tertiary hospital in Port Harcourt, Nigeria.

“…Sen et al (2012) also observed that the prevalence of ToRCH infection in and around Varanasi, Northern India, ranged from 19.4% (toxoplasmosis), 30.4% (Rubella virus), 34.7% (CMV), and 33.5% (HSV-2). Li et al (2023) found that ToRCH infections in southern China were 3.20 percent, 77.52%, and 75.90%. According to Karacan et al (2014), the prevalence of IgG antibodies was 95% for rubella, 84.1% for CMV, and 23.1% for T. gondii, whereas 93.7% of pregnant women tested positive for both IgG and IgM antibodies.…”

“…The term "ToRCH agents" refers to a class of infections that can be transmitted vertically, either intrauterinally, subpartum, or postnatally, and include pathogens such as Toxoplasma gondii, rubella virus, teratogenic cytomegalovirus (CMV), and types 1 and 2 of herpes simplex viruses (HSV-1 and HSV-2). These infections can cause significant congenital disabilities and even foetal death (Maldonado et al, 2011, Neu et al, 2015Wang et al, 2019;Warnecke et al, 2020;FPDRS, 2022;Boston Children's Hospital, 2022;Li et al, 2023). Additional pathogens associated with pregnancy include human parvovirus-B19, varicella zoster virus (VZV), Epstein-Barr virus (EBV), Bordetella pertussis, Chlamydia trachomatis, parvovirus-B19, Treponema pallidum, Coxsackie virus, and hepatitis B (Sadik et al, 2012;Neu et al, 2015;Wang et al, 2019;Warnecke et al, 2020;Li et al, 2023).…”

“…These infections can cause significant congenital disabilities and even foetal death (Maldonado et al, 2011, Neu et al, 2015Wang et al, 2019;Warnecke et al, 2020;FPDRS, 2022;Boston Children's Hospital, 2022;Li et al, 2023). Additional pathogens associated with pregnancy include human parvovirus-B19, varicella zoster virus (VZV), Epstein-Barr virus (EBV), Bordetella pertussis, Chlamydia trachomatis, parvovirus-B19, Treponema pallidum, Coxsackie virus, and hepatitis B (Sadik et al, 2012;Neu et al, 2015;Wang et al, 2019;Warnecke et al, 2020;Li et al, 2023).…”

Seroepidemiology study of rubella virus antibodies among neonates and pregnant women at hospitals in Henan province, China

“…People not vaccinated against rubella are at risk of getting rubella virus infection 3,4 . Most adults with rubella usually have a mild disease, with symptoms including fever, sore throat, red rash, nausea, and mild conjunctivitis 5 . The neonates infected with rubella usually have symptoms of red rash, low fever (<39°C), and some respiratory symptoms 6,7 .…”