Prevalence of serum antibodies to TORCH infection in the first trimester of the pregnancy in Kashan, Iran

Document Type : Original Article


1 Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

2 Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran

3 Refrence Labratory, Kashan University of Medical Sciences, Kashan, Iran.

4 Paramedicine college, Kashan University of Medical Sciences

5 Refrence Labratory, Kashan University of Medical Sciences, Kashan, Iran


Introduction:TORCH infections causing via Toxoplasma gondii, other microorganisms (e.g., Treponema pallidum), Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV) types 1 and 2 during the first trimester of pregnancy can lead to severe fetal anomalies or even fetal loss. The current study determined the serological data of TORCH infections in women who were in their first trimesters of pregnancy.This descriptive study was carried out on 80 pregnant women in their first trimester in Kashan, Iran.
Methods: To detect specific IgM antibodies and specific IgG antibodies against the TORCH infections via ELISA, Sera were collected from the pregnant women.
Results: The specific IgG antibodies were found to be positive in 30(37.5%) cases for toxoplasmosis, in 74 (92.5%) cases for the Rubella virus, in 79(98.8%) cases for CMV and in 73 samples (91.3%) for the HSV types 1 and 2 infection. 3.8% of cases were found to be seropositive for Toxoplasma IgM antibody (95% CI, 0.38-7.9), 5% were positive for CMV IgM antibody (95% CI, 0.23-9.77) and 7.5% were positive for the HSV IgM antibody (95% CI, 1.8-13.2). 63.8% of pregnant women were at risk for at least to one of the TORCH agents.
Conclusion: This study showed a high prevalence of infections caused by TORCH agents among pregnant women. Therefore, national screening programmed is necessary to screen the TORCH infections routinely and to prevent and treat congenital TORCH infection


  1. Rebouças E, Dos Santos E, Do Carmo M, Cavalcante Z, Favali C. Seroprevalence of Toxoplasma infection among pregnant women in Bahia, Brazil. Trans R Soc Trop Med Hyg. 2011; 105 (11):670-1.
  2. Gerber S, Hohlfeld P. Screening for infectious diseases. Child's Nervous System. 2003; 19(7-8):429-32.
  3. Kapil A, Broor S. Primary cytomegalovirus infection in pregnant and nonpregnant women in India. Indian J Med Microbiol. 1992; 10(1):53-5.
  4. Lawn JE, Yakoob MY, Haws RA, Soomro T, Darmstadt GL. Bhutta ZA: 3.2 million stillbirths: epidemiology and overview of the evidence review.BMC Pregnancy Childbirth. 2009; 9(Suppl 1):S2.
  5. McAuley JB, Boyer  KM,  Remington JS, McLeod RL. Toxoplasmosis.  In: Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL. editors. Textbook of Pediatric Infectious Diseases. 6th ed. Philadelphia: Saunders; 2009. p.2954.
  6. Remington JS, McLeod R, Wilson CB, Desmonts G. Toxoplasmosis. In: Remington, JS, Klein, JO, Wilson, CB, editors. Infectious Diseases of the Fetus and Newborn Infant. 7th ed Elsevier Saunders, Philadelphia. 2011;  p.918.
  7. Berger F, Goulet V, Le Strat Y, Desenclos JC. Toxoplasmosis among pregnant women in France: risk factors and change of prevalence between 1995 and 2003. Rev Epidemiol Sante Publique. 2009; 57(4): 241-8.
  8. Arbabi M, Farzad far H, Houshyar H. Prevalence of Toxoplasma gondii infection in Single Women Referring to Kashan Health Centers .Scientific-Research  Journal of Shahed University.  2009; 17 (83):7-12. (Persian).
  9. Cheng JQ, Zhou H, Hong FC, Zhang D, Zhang YJ, Pan P, et al. Syphilis screening and intervention in 500,000 pregnant women in Shenzhen, the  People's Republic of China. Sex Transm Infect. 2007; 83(5):347.

10. Centers for Disease Control and Prevention (CDC). Elimination of rubella and congenital rubella syndrome-United States, 1969-2004. MMWR Morb Mortal Wkly Rep. 2005; 54(11):279-82.

11. Centers for Disease Control and Prevention (CDC). Progress toward elimination of rubella and congenital rubella syndrome--the Americas, 2003-2008. MMWR Morb Mortal Wkly Rep. 2008; 57(43):1176-79.

12. Katow S. Molecular epidemiology of rubella virus in Asia: utility for reduction in the burden of diseases due to congenital rubella syndrome. Pediatr Int. 2004; 46(2):207-13.

13. Gandhoke I, Aggarwal R, Lal S, Khare S. Rubella in Delhi: in-utero infection and congenital rubella syndrome. Indian J Med Microbiol. 2008; 26(4):403.

14. Malakmadze N, Zimmerman LA, Uzicanin A, et al. Development of a rubella vaccination strategy: contribution of a rubella susceptibility study of women of childbearing age in Kyrgyzstan. 2001. Clin Infect Dis. 2004; 38(12):1780-3.

15. Arabzadeh AM, Mosavat SA, Eftekhari N. Seroepidemiology of Human Cytomegalovirus in Pregnant Women and their Neonates In Kerman City During 2005. Journal of Kerman University of Medical Sciences .2007; 14(4): 279-88.

16. Pembrey L, Raynor P, Griffiths P, Chaytor Sh, Wright J, Hall AJ. Seroprevalence of Cytomegalovirus, Epstein Barr Virus and Varicella Zoster Virus among Pregnant Women in Bradford: A Cohort Study. PLoS One. 2013; 8(11): e81881.

17. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection.Rev Med Virol. 2007;17(4):253-76.

  1. 18.  Ornoy A, Diav-Citrin O. Fetal effects of primary and secondary cytomegalovirus infection in pregnancy. Reprod Toxicol .2006; 21(4):399-409.
  2. 19.  Stagno S, Pass RF, Dworsky ME, Henderson RE, Moore EG, Walton PD,  et al. Congenital cytomegalovirus infection: The relative importance of primary and recurrent maternal infection. N Engl J Med. 1982; 306(16):945-9.

20. Fowler KB, Stagno S, Pass RF. Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA. 2003; 289(8):1008-11.

  1. 21.  Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA. 2003; 289(2):203-9.

22. Flagg EW, Weinstock H. Incidence of neonatal herpes simplex virus infections in the United States, 2006. Pediatrics. 2011; 127(1):e1-8.

23. Roberts S. Herpes simplex virus: incidence of neonatal herpes simplex virus, maternal screening, management during pregnancy, and HIV. Curr Opin Obstet Gynecol. 2009; 21(2):124-30.

24. Mahnert N, Roberts SW, Laibl VR, Sheffield JS, Wendel GD Jr.. The incidence of neonatal herpes infection. Am J Obstet Gynecol. 2007; 196(5):e55-6.

25. Bodéus M, Laffineur K, Kabamba-Mukadi B, Hubinont C, Bernard P, Goubau P. Seroepidemiology of herpes simplex type 2 in pregnant women in Belgium. Sex Transm Dis. 2004; 31(5):297-300.

26. Xu F, Markowitz LE, Gottlieb SL, Berman SM. Seroprevalence of herpes simplex virus types 1 and 2 in pregnant women in the United States. Am J Obstet Gynecol. 2007; 196(1):43.e1.

27. Li Z, Yan C, Liu P, Yan R, Feng Z. The prevalence of the serum anti-bodies to TORCH among women before pregnancy or in the early period of pregnancy in Beijing.Clin Chim Acta. 2009; 403(1-2): 212-15.