The Utility of Serologic TORCH Testing During Pregnancy for Maternal-related Versus Fetal-related Indications: A Retrospective Study.

IF 2.9 4区医学 Q3 IMMUNOLOGY Pediatric Infectious Disease Journal Pub Date : 2024-10-10 DOI:10.1097/INF.0000000000004591

Raneen Abu Shqara, Maya Kaufman, Shany Or, Daniel Glikman, Lior Lowenstein, Maya Frank Wolf

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Abstract

Background: Clear guidelines have not been established about the utility of TORCH serology testing in women for whom TORCH infection is suspected according to clinical and laboratory manifestations during pregnancy. We aimed to compare rates of TORCH infections [specifically cytomegalovirus (CMV), Toxoplasma and rubella] in women who underwent TORCH serology testing due to maternal- versus fetal-related indications.

Methods: This 10-year single-center retrospective study included all the women beyond 24 weeks of gestation who underwent TORCH serology testing due to maternal- or fetal-related indications. Maternal-related indications included fever, gastroenteritis, elevated liver enzymes and thrombocytopenia. Fetal-related indications included intrauterine growth restriction, polyhydramnios and oligohydramnios.

Results: During the study period, 304 women underwent TORCH serology testing due to maternal-related indications and 771 due to fetal-related indications. For the maternal-related compared with the fetal-related indication group, maternal and congenital TORCH infections were more prevalent (P = 0.015), specifically CMV (P = 0.036). Eight (2.6%) of the women with maternal-related indications had a primary TORCH infection; 4 of them (50%) had concomitant congenital infections. Six (0.8%) of the women with fetal-related indications had a primary infection; none had a related congenital infection. Among the women with maternal-related indications, higher rates of maternal TORCH infection were found among those with thrombocytopenia (7.1%) and elevated liver enzymes (3.0%). During the study period, maternal-indicated TORCH testing detected 10.8% of neonates born with a confirmed TORCH infection.

Conclusions: The clinical yield of TORCH serology for nonspecific sonographic fetal features was low. Nonetheless, maternal-related indications should prompt testing for CMV and Toxoplasma infection.

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妊娠期血清学 TORCH 检测对母体相关指标和胎儿相关指标的效用：一项回顾性研究。

背景：根据妊娠期间的临床和实验室表现，对怀疑感染 TORCH 的妇女进行 TORCH 血清学检测的效用还没有明确的指导方针。我们的目的是比较因母体和胎儿相关指征而接受 TORCH 血清学检测的妇女的 TORCH 感染率（特别是巨细胞病毒（CMV）、弓形虫和风疹）：这项为期 10 年的单中心回顾性研究包括所有妊娠超过 24 周、因母体或胎儿相关指征而接受 TORCH 血清学检测的妇女。母体相关指征包括发热、肠胃炎、肝酶升高和血小板减少。胎儿相关指征包括胎儿宫内发育受限、多羊水和少羊水：在研究期间，304 名妇女因母体相关指征而接受了 TORCH 血清学检测，771 名妇女因胎儿相关指征而接受了 TORCH 血清学检测。与胎儿相关指征组相比，母体和先天性 TORCH 感染更为普遍（P = 0.015），尤其是 CMV（P = 0.036）。在有母体相关指征的妇女中，有 8 人（2.6%）患有原发性 TORCH 感染；其中 4 人（50%）同时患有先天性感染。在有胎儿相关指征的妇女中，有 6 人（0.8%）有原发性感染；没有人有相关的先天性感染。在有母体相关指征的产妇中，血小板减少（7.1%）和肝酶升高（3.0%）的产妇感染 TORCH 的比例较高。在研究期间，经母体相关指征的 TORCH 检测发现，10.8% 的新生儿在出生时确诊感染了 TORCH：结论：针对胎儿非特异性声像图特征进行 TORCH 血清学检测的临床收益率较低。结论：针对非特异性声像图胎儿特征进行 TORCH 血清学检查的临床收益率较低。然而，与孕产妇相关的指征应提示进行 CMV 和弓形虫感染检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Infectious Disease Journal 医学-传染病学

CiteScore

6.30

自引率

2.80%

发文量

566

审稿时长

2-4 weeks

期刊介绍： The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.