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Serological Screening of TORCH Pathogen Infections in Infertile Women of Childbearing Age in Northwest China

  • Reproductive Epidemiology: Original Article
  • Published:
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Abstract

Serological screening for TORCH(Toxoplasma gondii [TOX], Rubella virus [RV], Cytomegalovirus [CMV], and Herpes simplex virus [HSV]) infections is an effective method for preventing congenital infections caused by TORCH pathogens.In this study, we retrospectively analyzed the characteristics of TORCH infections in 17,807 infertile women of childbearing age in northwest China.We conducted serological detection of TORCH-pathogen-specific IgM and IgG antibodies. The seroprevalence of TORCH infections was statistically analyzed by applying χ2 and Fisher exact-probability tests to evaluate the differences among ages and across quarters of the year. The overall IgM/IgG seroprevalences of TOX, RV, CMV, HSV-1, and HSV-2 were 0.46/3.4%, 0.77/84.93%, 0.68/97.54%, 1.2/82.83%, and 0.62/10.04%, respectively. The positive rates for RV-IgM in women ≥ 40 years old were significantly higher than those for women 25–39 (P < 0.05) years of age. The seroprevalence of HSV1-IgM was higher in the third and fourth quarters of the year (seasons) (P < 0.001), and the seroprevalence of CMV-IgG was statistically significant between differences quarters (P = 0.017), and the seroprevalence of CMV-IgG in the first quarter was lower than that in the third and fourth quarters (Bonferroni correction, P = 0.009 > 0.0083), suggesting no statistically significant difference between the latter two groups. This study showed that in northwestern China the risk of acquiring primary infection by a TORCH pathogen among infertile women of childbearing age were still high, especially Toxoplasma gondii and Herpesvirus type 2 infection. Therefore, effective prevention strategies that include serological screening for TORCH should be implemented.

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Data Availability

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

TOX :

Toxoplasma gondii

RV :

Rubella virus

CMV :

Cytomegalovirus

HSV :

Herpes simplex virus

IgM :

Immunoglobulin M

IgG :

Immunoglobulin G

ELISA :

Enzyme-linked immunosorbent assay

References

  1. Zhu Y, Shang S, Chen Y, Chen D, Jia L, Qu W, et al. Expert consensus on standardized TORCH laboratory detection and clinical application. Chin J Lab Med. 2020;43(5):553–61. https://doi.org/10.3760/cma.j.cn114452-20191020-00597.

    Article  Google Scholar 

  2. Neu N, Duchon J, Zachariah P. TORCH Infections. Clin Perinatol. 2015;42(1):77–103. https://doi.org/10.1016/j.clp.2014.11.001.

    Article  PubMed  Google Scholar 

  3. Nirmal K, Saha R, Ramachandran VG, Khan AM. TORCH infection in antenatal women: a 5-year hospital-based study. East J Med Sci. 2017;2(4):54–57. https://mansapublishers.com/index.php/ejms/article/view/671.

  4. Megli CJ, Coyne CB. Infections at the maternal-fetal interface: an overview of pathogenesis and defence. Nat Rev Microbiol. 2022;20(2):67–82. https://doi.org/10.1038/s41579-021-00610-y.

    Article  CAS  PubMed  Google Scholar 

  5. Wang Y, Li S, Ma N, Zhang Q, Wang H, Cui J, et al. The association of ToRCH infection and congenital malformations: a prospective study in China. Eur J Obstet Gynecol Reprod Biol. 2019;240:336–40. https://doi.org/10.1016/j.ejogrb.2019.04.042.

    Article  PubMed  Google Scholar 

  6. Lynn MK, Aquino MSR, Self SCW Kanyangarara M, Campbell BA, Nolan MS. TORCH congenital syndrome infections in Central America's Northern Triangle. Microorganisms. 2023;11(2):257. https://doi.org/10.3390/microorganisms11020257.

  7. Warnecke JM, Pollmann M, Borchardt-Lohölter V, Moreira-Soto A, Kaya S, Sener AG, et al. Seroprevalences of antibodies against ToRCH infectious pathogens in women of childbearing age residing in Brazil, Mexico, Germany, Poland Turkey and China. Epidemiol Infect. 2020;148:e271. https://doi.org/10.1017/S0950268820002629.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Singh G, Gaidhane A. A review of sensorineural hearing loss in congenital cytomegalovirus infection. Cureus. 2022;14(10):e30703. https://doi.org/10.7759/cureus.30703.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shi TL, Huang LJ, Xiong YQ, Zhong YY, Yang JJ, Fu T, et al. The risk of herpes simplex virus and human cytomegalovirus infection during pregnancy upon adverse pregnancy outcomes: a meta-analysis. J Clin Virol. 2018;104:48–55. https://doi.org/10.1016/j.jcv.2018.04.016.

    Article  PubMed  Google Scholar 

  10. Deka S, Kalita D, Gupta P, Mathuria YP. A contemporary insight into the sero-epidemiology of Toxoplasma gondii infection in the foot-hills of Himalayas: a cross-sectional study from a tertiary care center in Northern India. Nepal J Epidemiol. 2021;11(1):937–48. https://doi.org/10.3126/nje.v11i1.34228.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Al-Hakami AM, Paul E, Al-Abed F, Alzoani AA, Shati AA, Assiri MI, et al. Prevalence of toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections among women attending the antenatal care clinic, maternity hospital in Abha, Southwestern Saudi Arabia. Saudi Med J. 2020;41(7):757–762. https://doi.org/10.15537/smj.2020.7.25121.

  12. Palazzotto E, Bonura F, Calà C, Capra G, Pistoia D, Mangione D, et al. Serological status for TORCH in women of childbearing age: a decade-long surveillance (2012–2022) in Italy. J Med Microbiol. 2023;72(7). https://doi.org/10.1099/jmm.0.001733.

  13. Batra P, Batra M, Singh S. Epidemiology of TORCH Infections and Understanding the Serology in Their Diagnosis. J Fetal Med. 2020;7(1):25–9. https://doi.org/10.1007/s40556-019-00232-8.

    Article  Google Scholar 

  14. Rajendiran P, Saravanan N, Ramamurthy M, Sankar S, Aruliah R, Nandagopal B, et al. Standardization of an in-house multiplex real-time polymerase chain reaction for the simultaneous detection of Toxoplasma gondii, Rubella virus, cytomegalovirus, herpes simplex Virus 1 and 2, and Treponema pallidum infection among pregnant women. Indian J Public Health. 2021;65(4):369. https://doi.org/10.4103/ijph.ijph_1271_20.

    Article  PubMed  Google Scholar 

  15. Penner J, Hernstadt H, Burns JE, Randell P, Lyall H. Stop, think SCORTCH: rethinking the traditional ‘TORCH’ screen in an era of re-emerging syphilis. Arch Dis Child. 2021;106(2):117–24. https://doi.org/10.1136/archdischild-2020-318841.

    Article  PubMed  Google Scholar 

  16. Leung KKY, Hon KL, Yeung A, Leung AKC, Man E. Congenital infections in Hong Kong: an overview of TORCH. Hong Kong Med J. 2020;26(2):127–138. https://doi.org/10.12809/hkmj198287.

  17. Qin X, Zhang S, Liu H, Cheng G, Liu Y, Hu M, et al. Seroepidemiology of TORCH infections among 1.7 million women of childbearing age in rural China: a population-based cross-sectional study. Am J Trop Med Hyg. 2021;105(5):1202–1209. https://doi.org/10.4269/ajtmh.20-0137.

  18. Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Pre pregnancy and pregnancy health guidelines (2018). Chin J Perinat Med. 2018;21(3):145–152. https://doi.org/10.3760/cma.j.issn.1007-9408.2018.03.001.

  19. Wang W, Zhang Y, Chang Q, Meng X, Wei G, Li Y, et al. Analysis of TORCH infection status in natural infertile women and women of childbearing age during pre-pregnant health examination. Chin J Clin Lab Sci. 2022;40(5):391–395. https://doi.org/10.13602/j.cnki.jcls.2022.05.18.

  20. Wang LC, Yan F, Ruan JX, Xiao Y, Yu Y. TORCH screening used appropriately in China?─three years results from a teaching hospital in northwest China. BMC Pregnancy Childbirth. 2019;19(1):484. https://doi.org/10.1186/s12884-019-2642-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Bigna JJ, Tochie JN, Tounouga DN, Bekolo AO, Ymele NS, Youda EL, et al. Global, regional, and country seroprevalence of Toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis. Sci Rep. 2020;10(1):12102. https://doi.org/10.1038/s41598-020-69078-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Zhang L, Wang X, Liu M, Feng G, Zeng Y, Wang R, et al. The epidemiology and disease burden of congenital TORCH infections among hospitalized children in China: a national cross-sectional study. PLoS Negl Trop Dis. 2022;16(10):e0010861. https://doi.org/10.1371/journal.pntd.0010861.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kaushik A, Verma S, Kumar P. Congenital rubella syndrome: a brief review of public health perspectives. Indian J Public Health. 2018;62(1):52–4. https://doi.org/10.4103/ijph.IJPH_275_16.

    Article  PubMed  Google Scholar 

  24. Su Q, Feng Z, Hao L, Ma C, Hagan JE, Grant GB, et al. Assessing the burden of congenital rubella syndrome in China and evaluating mitigation strategies: a metapopulation modelling study. Lancet Infect Dis. 2021;21(7):1004–13. https://doi.org/10.1016/S1473-3099(20)30475-8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zhu Y, Zhang L. Laboratory measures after TORCH serological IgM positive before and during pregnancy. Chin J Lab Med. 2020;43(5):520–4. https://doi.org/10.3760/cma.j.cn114452-20191114-00669.

    Article  Google Scholar 

  26. Zhang X, Wang X, Gao X, Wen H. Investigation of TORCH infection in patients with spontaneous abortion based on IVF-ET technology. Lab Med Clin. 2023;20(7):920–4. https://doi.org/10.3969/j.issn.1672-9455.2023.07.014.

    Article  Google Scholar 

  27. Gugliesi F, Coscia A, Griffante G, Galitska G, Pasquero S, Albano C, et al. Where do we stand after decades of studying human cytomegalovirus? Microorganisms. 2020;8(5):685. https://doi.org/10.3390/microorganisms8050685.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Zuhair M, Smit GSA, Wallis G, Jabbar F, Smith C, Devleesschauwer B, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: a systematic review and meta-analysis. Rev Med Virol. 2019;29(3):e2034. https://doi.org/10.1002/rmv.2034.

    Article  PubMed  Google Scholar 

  29. Heald-Sargent TA, Forte E, Liu X, Thorp EB, Abecassis MM, Zhang ZJ, et al. New insights into the molecular mechanisms and immune control of cytomegalovirus reactivation. Transplantation. 2020;104(5):e118–24. https://doi.org/10.1097/TP.0000000000003138.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Plotogea M, Isam AJ, Frincu F, Zgura A, Bacinschi X, Sandru F, et al. An overview of cytomegalovirus infection in pregnancy. Diagnostics (Basel). 2022;12(10):2429. https://doi.org/10.3390/diagnostics12102429.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Hammad WAB, Konje JC. Herpes simplex virus infection in pregnancy – An update. Eur J Obstet Gynecol Reprod Biol. 2021;259:38–45. https://doi.org/10.1016/j.ejogrb.2021.01.055.

    Article  PubMed  Google Scholar 

  32. Zhu S, Viejo-Borbolla A. Pathogenesis and virulence of herpes simplex virus. Virulence. 2021;12(1):2670–702. https://doi.org/10.1080/21505594.2021.1982373.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL, et al. Herpes simplex virus: global infection prevalence and incidence estimates, 2016. Bull World Health Organ. 2020;98(5):315–29. https://doi.org/10.2471/BLT.19.237149.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Tookey PA, Mahdavi S, Peckham CS. Surveillance of neonatal herpes in the British Isles 2004–2006. F1000Res. 2020;9:163. https://doi.org/10.12688/f1000research.21538.1.

  35. Mahant S, Hall M, Schondelmeyer AC, Berry JG, Kimberlin DW, Shah SS, et al. Neonatal herpes simplex virus infection among medicaid-enrolled children: 2009–2015. Pediatrics. 2019;143(4):e20183233. https://doi.org/10.1542/peds.2018-3233.

    Article  PubMed  Google Scholar 

  36. Deka S, Kalita D, Paul M, Badoni G, Mathuria YP. Seroprevalence and determinants of ToRCH pathogens in pregnant women in the sub-Himalayan region. Cureus. 2022;14(2):e21946. https://doi.org/10.7759/cureus.21946.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chen L, Liu J, Shi L, Song Y, Song Y, Gao Y, et al. Seasonal influence on TORCH infection and analysis of multi-positive samples with indirect immunofluorescence assay. J Clin Lab Anal. 2019;33(4):e22828. https://doi.org/10.1002/jcla.22828.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Funding

This study was funded by the Science and Technology Innovation Project Plan of Shaanxi Province (2022PT-12).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Reproductive Medicine Center, Tang Du Hospital, The Air Force Military Medical University, Xi’an, China

    Xiaoyan Ren, Kaili Wang, Zhenhua Chang, Mengxin Liu, Fang Cheng, Baohua Min & Sanhua Wei

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Contributions

XYR and SHW designed the study. ZHC and MXL conducted data collection and management. XYR, FC and BHM performed the data analysis and interpretation, generated tables and figures, and drafted the manuscript. KLW and SHW critically revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sanhua Wei.

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The authors declare that they have no confict of interest.

Ethics approval and consent to participate

All methods were conducted in accordance with relevant guidelines and regulations. Due to the retrospective nature and all patient’s information was kept confidential, the study was deemed exempt from review and approved to be not require informed consent by the Institutional Review Board of Tang Du Hospital of the Air Force Military Medical University.

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Ren, X., Wang, K., Chang, Z. et al. Serological Screening of TORCH Pathogen Infections in Infertile Women of Childbearing Age in Northwest China. Reprod. Sci. (2024). https://doi.org/10.1007/s43032-024-01551-6

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