妊娠期妇女TORCH感染患者IgM和IgG的表达水平及妊娠结局

Expression levels of IgM and IgG in pregnant women with TORCH infection and their pregnancy outcomes

目的探讨妊娠期TORCH感染患者免疫球蛋白M(IgM)、免疫球蛋白G(IgG)的表达水平及妊娠结局分析。方法选取2017年1月-2019年10月华中科技大学同济医学院附属武汉儿童医院就诊的568例妊娠期妇女作为研究对象。回顾性分析孕妇的临床资料。根据妊娠结局分为不良妊娠组110例、正常妊娠组458例。检测两组妊娠期妇女以及新生儿脐血TORCH感染者IgM、IgG表达水平,并进行比较。结果568例孕妇中共18例TORCH-IgM阳性,阳性率为3.17%(18/568);不良妊娠组TORCH-IgM阳性率为7.27%(8/110)高于正常妊娠组的2.18%(10/458)(P=0.006)。568例中共14例TORCH-IgG抗体检测阳性,阳性率为2.46%(14/568);不良妊娠组TORCH-IgG阳性率为7.27%(8/110)高于正常妊娠组1.31%(6/458)(P<0.001)。脐血诊断中,16例TORCH-IgM检测阳性,占2.82%(16/568);10例TORCH-IgG检测阳性占1.76%(10/568);不良妊娠组TORCH-IgM、TORCH-IgG阳性率分别为10.91%(12/110)、7.27%(8/110)高于正常妊娠组0.87%(4/458)、0.44%(2/458)(P<0.05);Spearman相关分析显示,妊娠期妇女血清IgM阳性率、IgG阳性率与其不良妊娠结局呈正相关(r=0.432,P<0.001;r=0.458,P<0.001),孕妇所生新生儿脐血IgM阳性率、IgG阳性率也与不良妊娠结局呈正相关(r=0.332,P=0.04;r=0.258,P=0.015)。结论妊娠期妇女TORCH感染率高,且TORCH感染与不良妊娠结局密切相关,因此需加强孕期TORCH筛查。

OBJECTIVE To investigate the expression levels of immunoglobulin M(IgM)and immunoglobulin G(IgG)in pregnant women with TORCH infection and analyze their pregnancy outcomes.METHODS A total of 568 pregnant women who were treated in Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from Jan.2017to Oct.2019were selected as the research subjects,and the clinical data of pregnant women were retrospectively analyzed.According to pregnancy outcomes,they were divided into 110cases of adverse pregnancy group and 458cases of normal pregnancy group.The IgM and IgG expression levels in serum of pregnant women and in cord blood of neonates infected with TORCH were detected and compared.RESULTS There were 18cases of TORCH-IgM positive in 568pregnant women,with a positive rate of 3.17%(18/568).The positive rate of TORCH-IgM in the adverse pregnancy group was 7.28%(8/110),significently higher than that in the normal pregnancy group[2.18%(10/458)](P=0.006).A total of 14cases of 568 cases were positive for TORCH-IgG antibody,with a positive rate of 2.46%(14/568).The positive rate of TORCH-IgG in the adverse pregnancy group was 7.28%(8/110),significently higher than that in the normal pregnancy group[1.32%(6/458)](P<0.001).In umbilical cord blood diagnosis,16cases were positive for TORCH-IgM test,accounting for 2.82%(16/568)and 10cases were positive for TORCH-IgG test,accounting for 1.76%(10/568).The positive rates of TORCH-IgM and TORCH-IgG in the adverse pregnancy group were 10.92%(12/110)and 7.28%(8/110),respectively,significently higher than those in the normal pregnancy group[0.88%(4/458)and 0.44%(2/458),respectively](P<0.05).Spearman correlation analysis showed that positive rates of serum IgM and IgG in pregnant women were positively correlated with adverse pregnancy outcomes(r=0.432,P<0.001;and r=0.458,P<0.001,respectively),and the positive rates of IgM and IgG in neonatal umbilical cord blood of pregnant women were also positively correlated with adverse pregnancy outcomes(r=0.332,P=0.04;and r=0.258,P=0.015,respectively).CONCLUSION Pregnant women had a high TORCH infection rate,and TORCH infection was closely related to adverse pregnancy outcomes.Therefore,screening of TORCH during pregnancy should be strengthened.