Evaluation of Toxoplasma gondii, CMV, and Rubella Seropositivity and Avidity Tests in the First Trimester of Pregnancy: Why to Test?

Abstract

Objective: The influence of intrauterine and perinatal infections on fetal and neonatal mortality rates and childhood morbidity is substantial. Toxoplasmosis gondii, cytomegalovirus (CMV), and rubella are widely recognized as the major causative agents of in utero infection. The surveillance of preventable and treatable diseases within populations at risk are crucial for public health. The objective of this study is to investigate the seropositivity rates and avidity incidences of T. gondii, CMV, and rubella in pregnant women during the first trimester. Methods: The electrochemiluminescence immunoassay method (Elecsys, Roche, Germany) was employed for the detection of the anti-Toxo IgM, anti-Toxo IgG, anti-CMV IgM, anti-CMV IgG, anti-rubella IgM, and anti-rubella IgG during the time period of January 1, 2021, to June 15, 2023. The anti-Toxo IgG, anti-CMV, and anti-rubella IgG avidity tests were performed with the enzyme-linked fluorescent assay method (VIDAS, bioMérieux, France). Results: The T. gondii IgM incidance was 2.1%; and the T. gondii IgG seroprevalance was 22%. For T. gondii, low avidity was observed in 13.6% (n = 31) of cases, while high avidity index was detected in 75.8% (n = 172) of cases. The anti-CMV IgM incidance was 1.6%; while IgG seroprevalance was 96.9%. The IgG avidity with a high index for CMV was determined as 99.4%. The anti-rubella IgM incidance was 0.8%; while the IgG seroprevalance was found to be 98.7%. The IgG avidity with a high index for Rubella was 99.1%. Conclusion: Seroprevalance of T.gondii, CMV, and rubella may vary according to geographical and socioeconomic conditions. Treatment for T. gondii diagnosed during pregnancy, preventive behavioral measures for CMV and vaccination against rubella prior to pregnancy may help reduce congenital infections. The prioritization of T. gondii, CMV, and rubella screening in high-risk populations, including women of reproductive age and pregnant women, is crucial for public health.