孕妇弓形虫感染妊娠结局及危险因素调查

Investigation on pregnancy outcomes and risk factors in pregnant women infected with Toxoplasma gondii

目的了解孕妇感染弓形虫感染后的妊娠结局及其危险因素。方法 2010-2013年采用酶联免疫吸附试验(ELISA)对在涿州市妇幼保健院行孕前检查的2 740例孕期妇女进行弓形虫IgM和IgG抗体检测并追踪随访,观察其妊娠结局;采用问卷调查孕妇弓形虫感染的危险因素。结果 2 740例被调查的孕期妇女中,弓形虫抗体检测阳性195例,抗体阳性率为7.12%,其中IgM抗体阳性44例(占22.56%),IgG抗体阳性151例(占77.44%)。随访结果表明,195例感染弓形虫的孕妇中41例出现不良妊娠结局(占21.02%),包括32例IgM抗体阳性孕妇(占78.05%)和9例IgG抗体阳性(占21.95%);未感染弓形虫孕妇6例出现不良妊娠结局(占2.86%),两者差异有统计学意义(P<0.05)。问卷调查表明,与动物密切接触、喜吃生肉、喜吃火锅或烧烤、品尝生肉馅等是孕妇感染弓形虫的重要危险因素(与未感染组比较,P<0.01)。结论孕妇感染弓形虫可导致不良妊娠结局的发生,养成良好的生活卫生习惯是避免不良妊娠结局的有效途径。

Objective To understand the pregnancy outcomes and risk factors in pregnant women infected with Toxoplasma gondii. Methods Toxoplasma IgM and IgG antibodies in sera from 2 740 cases of pregnant women were detected by using enzyme-linked immunosorbent assay（ELISA）in Zhuozhou Municipal Maternal and Child Health Care Center from 2010 to 2013,and the pregnancy outcomes were followed up. The risk factors for Toxoplasma infection were investigated with questionnaires. Results Among the 2 740 cases of pregnant women,195 cases were found with antibodies to T. gondii（7.12%）,and among them,44 cas-es were IgM positive（22.56%）,and 151 cases were IgG positive（77.44%）. There were 41 cases with adverse pregnancy out-comes among the 195 cases（21.02%）,including 32 cases of IgM positive（78.05%）and 9 cases of IgG positive（21.95%）. There were 6 cases of adverse pregnancy outcomes in uninfected pregnant women（2.86%）. The difference between the two groups was statistically significant（P＆lt;0.05）. The close contact with animals,eating raw meat,eating chafing dish or barbeque,and eating raw meat stuffing were important risk factors in pregnant women infected with T. gondii（compared with the uninfected group,P＆lt;0.01）. Conclusion The Toxoplasma infection may lead to adverse pregnancy outcomes,therefore,to develop good habits of life and health is an effective way to avoid adverse pregnancy outcomes.