妊娠期妇女弓形体感染对胎婴儿生长发育的影响

目的　探讨妊娠期妇女弓形体 (Tox)感染对胎婴儿生长发育的影响。方法　采用酶联免疫吸附法检测 3 90 8例孕妇外周血中Tox IgM ,对Tox IgM阳性孕妇进一步检测其新生儿脐血中Tox IgM ;应用聚合酶链反应技术检测孕妇流产物中Tox DNA ,其中新生儿脐血Tox IgM或绒毛膜组织中Tox DNA阳性者 95例为感染组 ,阴性者 1 1 9例为非感染组。采用不同监测方法动态观察两组孕妇的妊娠结局和新生儿出生后 3个月及 1 2个月时智力发育状况 ,以及采用早期干预措施后出生 1年及 4年的两组婴幼儿语言IQ、操作IQ及总IQ。结果　感染组孕妇发生流产 1 2例 (1 2 6 % )、死胎 5例(5 3 % )、早产 4例 (4 2 % )、胎儿生长受限 (FGR) 4例 (4 2 % )及畸形 3例 (3 2 % )。非感染孕妇组发生流产 3例 (2 7% )、死胎 1例 (0 9% )、早产 2例 (1 8% )、FGR 2例 (1 8% )及胎儿畸形 1例 (0 9% )。两组比较 ,差异有极显著性 (P <0 0 1 )。感染组的相对危险度 (RR)分别为 :流产 4 7、死胎 5 9、早产 2 3、FGR 2 3及胎儿畸形 3 6。感染组婴幼儿智力发育指数为 93± 1 3 ,运动发育指数为 1 0 1± 1 6。明显低于非感染组的 1 0 7± 1 7和 1 1 1± 1 3 ,两组比较 ,差异有显著性 (P <0 0 5)。采用干预措施后出生 1年及4年 ,感染组婴幼儿语

Effect of toxoplasma infection during pregnancy to the development of fetus and infant

OBJECTIVE: To investigate the effect of Toxoplasma (Tox) infection during pregnancy to the development of fetus and infant. METHODS: Enzyme linked immunoadsorbent assay (ELISA) was employed to detect Tox-IgM in peripheral blood of 3,908 pregnant women. To Tox-IgM positive cases, the umbilical blood of their neonates were sampled to detect Tox-IgM and abortion tissues were sampled to detect Tox-DNA with polymerase chain reaction. Infection group included 95 cases whose Tox-IgM or DNA were positive, and control group consisted of 119 cases without infection. Different supervision methods were used to periodically observe the intelligence development of infants 3 and 12 months after birth in these two groups. After initial intervention, verbal intelligence quotients (VIQs), performance intelligence quotients (PIQs) and full scale intelligence quotients (FSIQs) were assessed when the infants were 1 and 4 years old of these two groups. RESULTS: The incidences of abortion, stillbirth, pre-term delivery, FGR and malformation in infection group were 12 cases (12.6%), 5 cases (5.3%), 4 cases (4.2%), 4 cases (4.2%) and 3 cases (3.2%), while the incidences of these abnormalities in control group were 3 cases (2.7%), 1 cases (0.9%), 2 cases (1.8%), 2 cases (1.8%) and 1 cases (0.9%). Comparing with these two groups, there was significant difference (P < 0.01). Relative risk (RR) of these 5 abnormalities was 4.7, 5.9, 2.3, 2.3 and 3.6 respectively. Mental development index (MDI) and psychomotor development index (PDI) of infants in infection group were 93 +/- 13 and 101 +/- 16. They were significantly lower than that of control group, which were 107 +/- 17 and 111 +/- 13. There was significant difference between these two groups (P < 0.05). After intervention in 1 and 4 years, their VIQs, PIQs and FSIQs were apparently improved (P < 0.05). CONCLUSION: Congenital Tox infection is closely correlated with abnormal pregnancy outcomes and infantile mental retardation. Early intervention can improve intelligence development.