弓形虫感染与孕妇自发性流产相关性的病例对照研究

Correlation between Toxoplasma gondii infection and spontaneous abortion in pregnant women: a case-control study

目的分析刚地弓形虫感染与孕妇自发性流产的相关性,为制定自发性流产预防措施提供参考依据。方法以2018年1月至2019年12月采集的228份首次自发性流产孕妇血清样本作为病例组,以同期正常妊娠且无流产史的228份孕妇血清作为对照组。采用酶联免疫吸附试验(ELISA)检测并比较病例组和对照组血清抗弓形虫IgG和IgM抗体检出率,分析弓形虫感染与自发性流产的相关性。结果病例组年龄、学历构成、职业构成、居住地、养猫比例等差异均无统计学意义(P均> 0.05)。病例组血清抗弓形虫IgM抗体阳性率为3.51%,对照组为0.44%,两组差异有统计学意义(校正χ~2=4.08,P <0.05;OR=8.25);病例组血清抗弓形虫IgG抗体阳性率为10.09%,对照组为8.30%,两组差异无统计学意义(χ~2=0.42,P> 0.05)。结论孕期急性弓形虫感染可显著增加自发性流产发生率,应加强孕前弓形虫病相关知识健康教育和孕期弓形虫感染检测。

Objective To examine the correlation between Toxoplasma gondii infection and spontaneous abortion among pregnant women,so as to provide the evidence for the development of preventive measures for spontaneous abortion.Methods A total of 228 serum samples collected from women with spontaneous abortion for the first time from January 2018 to December2019 were selected as the case group,while 228 serum samples collected from pregnant women with a normal delivery and without a history of abortion during the same period were selected as the control group.The serum IgG and IgM antibodies against T.gondii were detected and compared in both groups,and the correlation between T.gondii infection and spontaneous abortion was evaluated.Results There were no significant differences between the case and control groups in terms of age,education levels,occupation,residency and proportion of keeping cats(all P values> 0.05).The positive rate of anti-T.gondii IgM antibody was significantly higher in the case group than in the control group(adjusted χ~2=4.08,P <0.05;OR=8.25),while no significant difference was seen between the case and control groups(χ~2=0.42,P> 0.05).Conclusions Acute maternal T.gondii infection may remarkably increase the chance of spontaneous abortion.Progestational health education regarding toxoplasmosis prevention and control knowledge and detection of T.gondii infection during pregnancy should be strengthened.