重庆市孕前妇女TORCH感染现状及妊娠结局分析

Analysis of infection status and pregnancy outcome of TORCH in preconception women in Chongqing

目的探讨重庆市孕前妇女TORCH[弓形虫(TOX)、柯萨奇病毒(O)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(H)]感染情况及流行病学特点,为重庆地区妇女孕前保健提供依据。方法收集2017年1月至2019年12月该院妇女保健科进行孕前检查的育龄期妇女血清标本4009例,测定血清CMV、RV、TOX免疫球蛋白M(IgM)和IgG抗体,分析总体感染状况及不同年龄、年份感染状况;1年后随访IgM抗体阳性者妊娠结局。结果4009例样本中CMV、RV、TOX IgM抗体阳性率分别为3.04%(122/4009)、0.85%(34/4009)、0.80%(32/4009),CMV、RV、TOX IgG抗体阳性率分别为90.70%(3636/4009)、91.89%(3684/4009)、2.39%(96/4009)。不同年龄妇女CMV IgM抗体阳性率比较,差异有统计学意义(P<0.05);不同年份妇女CMV、RV IgM抗体阳性率比较,差异均有统计学意义(P<0.05)。TORCH IgM抗体阳性妇女不良妊娠发生率明显高于阴性者,差异有统计学意义(P<0.05)。结论重庆市育龄期妇女TORCH感染较为普遍,不同年龄、年份妇女感染率存在明显差异,且TORCH阳性妇女不良妊娠发生率明显高于阴性者。因此,孕前筛查TORCH感染非常重要。

Objective To analyze the prevalence and epidemiological characteristics of TORCH[Toxoplasma gondii(TOX),coxsackie virus(O),rubella virus(RV),cytomegalovirus(CMV),herpes simplex virus(H)]infection among women undergoing preconception examination in Chongqing,and provide evidence for preconception health care.Methods A total of 4009 serum samples were collected from women of childbearing age who were participated in the examination of preconception in Department of Women′s Health of the hospital from January 2017 to December 2019.IgM and IgG antibodies of CMV,RV and Tox in serum were determined.The overall infection status and infection status of different age groups and years were analyzed.The pregnancy outcomes of IgM-positive patients were followed up after one year.Results The positive rate of CMV IgM was 3.04%(122/4009),RV IgM was 0.85%(34/4009),TOX IgM was 0.80%(32/4009).The positive rate of CMV IgG was 90.70%(3636/4009),RV IgG was 91.89%(3684/4009),TOX IgG was 2.39%(96/4009).There was significant difference in the positive rate of CMV IgM between different age groups(P<0.05),and significant differences in CMV IgM and RV IgM between different years(P<0.05).The adverse pregnancy rate in the TORCH IgM positive group was significantly higher than that in the negative group(P<0.05).Conclusion TORCH infection is common among women of childbearing age in Chongqing,and there are obvious differences in infection rates among different ages and years,and the incidence of adverse pregnancy in the TORCH positive group was significantly higher than that in the negative group.Therefore,screening for TORCH infection before pregnancy is very important.