The Impact of Latent Toxoplasma gondii Infection on Spontaneous Abortion History and Pregnancy Outcomes: A Large-Scale Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Population, and Setting
2.2. Detection of IgG Antibodies against Toxoplasma gondii, CMV and Rubella virus
2.3. Statistical Analysis
2.4. Ethical Issues
3. Results
3.1. Demographic and Clinical Features of Pregnant Women Included in the Study
3.2. Latent Toxoplasma gondii Infection and the Rate of Previous Spontaneous Abortion
3.3. Latent Toxoplasma gondii Infection and the Course of Pregnancy with Respect to the Neonatal Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Pregnant Women (n = 806) | N (%), Median [IQR] | N (%), Median [IQR] | |||
---|---|---|---|---|---|
Pregnancy outcome | |||||
Age of women (years) b | 28 [25–31] | Birth mode a | Vaginal | 470 (58.3%) | |
Provenance a | Rural | 219 (27.2%) | Cesarean | 336 (41.7%) | |
Urban | 585 (72.6%) | Spontaneous rupture of membrane a | No | 601 (74.8%) | |
Unknown | 2 (0.2%) | Yes | 202 (25.2%) | ||
Smoker a | No | 673 (83.5%) | Placenta insertion a | Normal | 799 (99.1%) |
Yes | 92 (11.4%) | Previa | 7 (0.9%) | ||
Unknown | 28 (3.5%) | Placental abruption a | No | 803 (99.6%) | |
Stopped | 13 (1.6%) | Yes | 3 (0.4%) | ||
Height (cm) b | 165 [160–168] | PIH a | No | 775 (96.6%) | |
Weight—at onset of pregnancy (kg) b | 59 [53–67] | Yes | 27 (3.3%) | ||
BMI—at onset of pregnancy (g/m2) b | 21.8 [19.7–25.0] | Neonatal outcome | |||
Gestation a | 1 | 341 (42.3%) | Gender a | Girls | 402 (49.9%) |
2 | 261 (32.4%) | Boys | 404 (50.1%) | ||
3 | 115 (14.3%) | APGAR 1’ a | <7 | 23 (2.9%) | |
4 | 55 (6.8%) | 8–9 | 658 (81.6%) | ||
5 | 18 (2.2%) | 10 | 61 (7.6%) | ||
6 | 7 (0.9%) | Unknown | 52 (7.9%) | ||
7 | 5 (0.6%) | APGAR 5’ a | <7 | 6 (0.7%) | |
8 | 2 (0.2%) | 8–9 | 650 (80.6%) | ||
10 | 1 (0.1%) | 10 | 98 (12.2%) | ||
13 | 1 (0.1%) | Unknown | 52 (6.5%) | ||
History of spontaneous abortion a | 0 | 722 (89.6%) | Birthweight (g) a | <1500 | 6 (0.7%) |
1 | 62 (7.7%) | 1500–2500 | 39 (4.8%) | ||
2 | 20 (2.49%) | 2500–4000 | 723 (89.7%) | ||
3 | 2 (0.25%) | >4000 | 38 (4.7%) | ||
Previous cesarean a | No | 742 (92.1%) | GA (weeks) a | <28 | 0 (0.0%) |
IgG anti-TG a | Yes | 64 (7.9%) | 29–32 | 7 (0.9%) | |
Negative | 463 (57.4%) | 33–34 | 11 (1.4%) | ||
Positive | 343 (42.6%) | 35–37 | 57 (7.1%) | ||
Pregnancy outcome | 37–43 | 731 (90.7%) | |||
Presentation at delivery a | Cephalic | 756 (93.8%) | GA (days) b | 273 [267–278] | |
Breech | 50 (6.2%) | Birthweight (MoM) b | 0.998 [0.923–1.017] |
TG IgG Antibodies | OR [CI] | p Value | |||||
---|---|---|---|---|---|---|---|
Positive | Negative | ||||||
Number | N% | Number | N% | ||||
Obstetrical history | |||||||
A—counted as persons (n = 465) | Pregnancies | 171 | 79.9% | 210 | 83.6% | 1.288 [0.902–2.067] | 0.333 |
SA | 43 | 20.1% | 41 | 16.3% | |||
B—counted as pregnancies (n = 828) | Pregnancies | 354 | 86.1% | 366 | 87.7% | 1.156 [0.770–1.733] | 0.536 |
SA | 57 | 13.8% | 51 | 12.2% |
TG IgG Antibodies | OR [CI] | p Value | |||||
---|---|---|---|---|---|---|---|
Negative | Positive | ||||||
Count | N% | Count | N% | ||||
a. Pregnancy complications | |||||||
Fetal presentation | Cephalic | 429 | 92.7% | 327 | 95.3% | 0.617 [0.335–1.138] | 0.078 |
Non-cephalic | 34 | 7.3% | 16 | 4.7% | |||
Mode of delivery | Vaginal | 271 | 58.5% | 199 | 58% | 1.021 [0.770–1.356] | 0.884 |
Cesarean | 192 | 41.5% | 144 | 42% | |||
Spontaneous rupture of membranes | No | 347 | 74.9% | 254 | 74.1% | 1.013 [0.734–1.398] | 0.935 |
Yes | 116 | 25.1% | 86 | 25.9% | |||
Placental insertion | Normal | 460 | 99.4% | 339 | 98.8% | 1.809 [0.402–8.137] | 0.467 |
Praevia | 3 | 0.6% | 4 | 1.2% | |||
Placental abruption | No | 460 | 99.4% | 343 | 100% | 0.994 [0.986–1.001] | 0.266 |
Yes | 3 | 0.6% | 0 | 0% | |||
Pregnancy-induced hypertension | No | 448 | 96.8% | 331 | 96.5% | 1.083 [0.500–2.344] | 0.846 |
Yes | 15 | 3.2% | 12 | 3.5% | |||
b. Neonatal features | |||||||
Secondary sex ratio | Girls | 233 | 50.3% | 169 | 49.3% | 1.043 [0.789–1.379] | 0.776 |
Boys | 230 | 49.7% | 174 | 50.7% | |||
APGAR 1′ | <7 | 12 | 2.8% | 11 | 3.5% | 1.660 [0.627–4.40] | 0.544 |
8–9 | 380 | 88.2% | 278 | 89.4% | 1.285 [0.743–2.20] | ||
10 | 39 | 9% | 22 | 7.1% | R | ||
APGAR 5′ | <7 | 3 | 0.7% | 3 | 0.9% | 1.551 [0.228–7.93] | 0.881 |
8–9 | 373 | 85.9% | 277 | 86.6% | 1.079 [0.700–1.66] | ||
10 | 58 | 13.4% | 40 | 12.5% | R | ||
Birth weight categories (grams) | ≤1500 | 5 | 1.1% | 1 | 0.3% | 0.282 [0.032–2.436] | 0.350 |
1501–2500 | 22 | 4.8% | 17 | 5.0% | 1.063 [0.554–2.039] | ||
2501–4000 | 418 | 90.3% | 305 | 88.9% | R | ||
>4000 | 18 | 3.9% | 20 | 5.8% | 1.526 [0.793–2.936] | ||
Gestational age at birth categories (weeks) | <32 | 6 | 1.3% | 1 | 0.3% | 0.221 [0.026–1.848] | 0.434 |
32–33 | 5 | 1.1% | 6 | 1.7% | 1.591 [0.480–5.267] | ||
34–36 | 36 | 7.8% | 21 | 6.1% | 0.773 [0.440–1.358] | ||
37–39 | 325 | 70.2% | 245 | 71.4% | R | ||
≥40 | 91 | 19.7% | 70 | 20.4% | 1.020 [0.716–1.452] | ||
Median [IQR] | Median [IQR] | ||||||
Gestational age (days) | 273 * [266–278] | 273 * [267–279] | 0.491 | ||||
Birth weight (MoM) | 0.99 * [0.922–1.067] | 1.01 * [0.929–1.089] | 0.257 | ||||
Length (cm) | 50 * [49–52] | 50 * [49–52] | 0.232 | ||||
Head circumference (cm) | 34 * [33–35] | 34 * [33–35] | 0.973 |
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Mocanu, A.G.; Stoian, D.L.; Craciunescu, E.L.; Ciohat, I.M.; Motofelea, A.C.; Navolan, D.B.; Vilibic-Cavlek, T.; Stevanovic, V.; Nemescu, D.; Forga, M.; et al. The Impact of Latent Toxoplasma gondii Infection on Spontaneous Abortion History and Pregnancy Outcomes: A Large-Scale Study. Microorganisms 2022, 10, 1944. https://doi.org/10.3390/microorganisms10101944
Mocanu AG, Stoian DL, Craciunescu EL, Ciohat IM, Motofelea AC, Navolan DB, Vilibic-Cavlek T, Stevanovic V, Nemescu D, Forga M, et al. The Impact of Latent Toxoplasma gondii Infection on Spontaneous Abortion History and Pregnancy Outcomes: A Large-Scale Study. Microorganisms. 2022; 10(10):1944. https://doi.org/10.3390/microorganisms10101944
Chicago/Turabian StyleMocanu, Adelina Geanina, Dana Liana Stoian, Emanuela Lidia Craciunescu, Ioana Mihaela Ciohat, Alexandru Catalin Motofelea, Dan Bogdan Navolan, Tatjana Vilibic-Cavlek, Vladimir Stevanovic, Dragos Nemescu, Marius Forga, and et al. 2022. "The Impact of Latent Toxoplasma gondii Infection on Spontaneous Abortion History and Pregnancy Outcomes: A Large-Scale Study" Microorganisms 10, no. 10: 1944. https://doi.org/10.3390/microorganisms10101944