Gebelerde Toxoplasma gondii, Rubella ve Sitomegalovirüs Seroprevalansı: Ülke Geneli Çok Merkezli Çalışma

Yıl 2023, , 171 - 176, 01.11.2023

Gülnur Kul , Selma Tosun , Sebahat Aksaray , Yusuf Ustun , Gunay Tuncer Ertem , Şebnem Alanya Tosun , İlknur Şenel , Fethiye Akgül , Fatma Yılmaz-karadağ , Canan Satır Özel , Birol Şafak , Habibe Tülin Elmaslar Mert , Nesibe Korkmaz , Emine Günal , Serdar Güngör , Hüseyin Haydar Kutlu , Halil Kurt , Yasemın Ardıcoglu Akışın , Kadriye Karahangil , Sibel Yıldız Kaya

https://doi.org/10.38175/phnx.1289083

Öz

Amaç: Toksoplazma gondii (T. gondii), Rubella ve Cytomegalovirüs (CMV)etkenlerinin neden olduğu TORCH grubu enfeksiyonları sağlıklı yetişkinlerde asemptomatik seyrederken, gebelik döneminde vertikal bulaşla fetal morbidite ve mortalite ile sonuçlanabilir. Günümüzde gebelik sırasında bu enfeksiyon etkenlerinin rutin taraması konusunda net bir fikir birliği yoktur. Çalışmamızda ülke genelinde toxoplazma gondii, rubella ve sitomegalovirus enfeksiyonlarının gebelik dönemindeki seroprevelans durumunun belirlenmesi ve diğer ülkelerin verileriyle karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Çalışma çok merkezli, retrospektif, tanımlayıcı kesitsel bir araştırma olarak planlanmıştır. Çalışmamıza 2011-19 yılları arasında, ikinci basamak devlet hastanesi, üçüncü basamak eğitim araştırma hastanesi ve üniversite hastanelerine o yıl kuruma başvuran gebe sayısı, o yıl toksoplazma, rubella ve sitomegalovirus tetkiki yapılan gebe sayısı, IgM ve IgG sonuçları ve ulaşılabilirse toksoplazma ve sitomegalovirus avidite test sonuçları kaydedilmiştir. Rubella IgG negatif olan hastaların yaşları dahil edilmiştir.
Bulgular: Türkiye’nin on farklı ilindeki ikinci ve üçüncü basamak sağlık kuruluşlarından toplam 15 merkezin katıldığı bu çalışmada, bu merkezlere başvurmuş ve gebelik durumu olan toplam 354526 kişiden elde edilen veriler sonucunda; anti toksoplazma IgG seropozitifliği %21, anti rubella IgG seropozitifliği %96.5, anti CMV Ig G seropozitifliği %56.2 bulunmuştur. Çalışmamızda anti rubella IgG negatif gebelerin yaşları değerlendirilmiştir. Rubella IgG negatif 2024 gebenin yaş ortalaması 30.6 yıl (18-54) bulunmuştur. Yaş aralıklarına göre incelendiğinde seronegatifliğin en çok 30-39 yaş aralığında olduğu görülmüştür.
Sonuç: Gebelerde toksoplazma, rubella ve sitomegalovirus enfeksiyonu sıklığı ve yaygınlığı hakkında bilgi sahibi olmak, hastalık yükünün belirlenmesinde, tarama programlarının planlanmasında ve birinci basamak sağlık hizmetlerinin aktif kullanımında kritik bir rol oynamaktadır. Aşılama ile bağışıklığın sağlanabildiği rubella enfeksiyonu için seronegatif bireylerin tespit edilip gebelik öncesi aşılanması önemlidir.

Anahtar Kelimeler

Gebelik, toksoplazma, rubella, sitomegalovirus

Seroprevalence of Toxoplasma gondii, Rubella and Cytomegalovirus in Pregnant Women: A Countrywide Multicenter Study

Öz

Objective: Objective: While TORCH infections caused by Toxoplasma gondii (T. gondii), Rubella and Cytomegalovirus (CMV) agents are asymptomatic in healthy adults, vertical transmission during pregnancy may result in fetal morbidity and mortality. Currently, there is no clear consensus on routine screening for these infectious agents during pregnancy. In our study, it was aimed to determine the seroprevalence status of toxoplasma gondii, rubella and cytomegalovirus infections throughout the country during pregnancy and to compare them with the data of other countries.
Material and Method: The study was planned as a multicenter, retrospective, descriptive cross-sectional study. The number of pregnant women who applied to the secondary level state hospital, tertiary education research hospital and university hospitals that year between 2011-19, the number of pregnant women who were tested for toxoplasma, rubella and cytomegalovirus that year, IgM and IgG results, and toxoplasma and cytomegalovirus if available. avidity test results were recorded. Ages of patients who were Rubella IgG negative were included.
Results: In this study, in which a total of 15 centers from secondary and tertiary health institutions in ten different provinces of Turkey participated, as a result of the data obtained from a total of 354526 people who applied to these centers and had pregnancy; anti toxoplasma IgG seropositivity was 21%, anti rubella IgG seropositivity was 96.5%, anti CMV IgG seropositivity was 56.2%. In our study, the ages of anti rubella Ig G negative pregnant women were evaluated. The mean age of 2024 Rubella IgG negative pregnant women was 30.6 years (18-54). When examined according to age ranges, it was seen that seronegativity was mostly in the 30-39 age range.
Conclusion: Having information about the frequency and prevalence of toxoplasma, rubella and cytomegalovirus infections in pregnant women plays a critical role in determining the burden of disease, planning screening programs and active use of primary health care services. It is important to detect seronegative individuals and vaccinate before pregnancy for rubella infection, in which immunity can be achieved by vaccination.

Anahtar Kelimeler

Pregnancy, toxoplasma, rubella, cytomegalovirus

Kaynakça

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