Detection of Toxoplasmosis in Association with Autoimmune Thyroid Disease During Pregnancy in Duhok, Iraq

Abstract

Toxoplasma gondii is a protozoan parasite that is widely distributed in the human population and is responsible for corresponding global morbidity. Specifically, T. gondii causes toxoplasmosis, leading to miscarriage, stillbirth, and neural disorders. This parasite attacks different human organs and glands, such as the thyroid gland, and causes various corresponding health issues. Recently, studies have established a link between T. gondii and autoimmune thyroid diseases (AITD), which contributes to preterm delivery, miscarriage, low birth weight, and death. Therefore, the aim of this study was to detect the prevalence of toxoplasmosis and its association with AITD among pregnant women. A total of 180 blood samples were collected from pregnant women and examined using an enzyme-linked immunosorbent assay (ELISA). The patients were within the age range of 15–50 years old, and lived in Duhok City, Iraq; samples and clinical information was collected from August 2021 to February 2022. The corresponding blood samples were tested for anti-Toxoplasma IgG antibody, Toxoplasma IgG avidity, FT3, FT4, and TSH hormones, and TPO, Tg, and TSHR antibodies. Overall, our results showed that out of 180 pregnant women, 110 (61.1%) were seropositive for anti-Toxoplasma IgG antibody; specifically, 25 (22.7%) and 85 (77.3%) had recent and past infections, respectively. Approximately 54.4% (98) of the pregnant women had thyroid disorders; further, 22 (12.2%), 13 (7.2%), and 8 (4.4%) women had TPO, Tg, and TSHR antibodies, respectively. A total of 43 (23.8%) patients screened positive for AITD. Out of the 110 Toxoplasma IgG–positive women, 35 (31.8%) had AITD. The older women, rural residents, restaurant food consumers, and women with cat contact had relatively high infection rates. Toxoplasma seropositive women had more elevated autoantibodies than seronegative ones. In conclusion, this study demonstrated a high rate of toxoplasmosis and a corresponding association with thyroid hormones changes and AITD in pregnant women in Duhok, Iraq. Further, it is necessary to reduce overall infection rates through effective health and educational programs. Therefore, it is essential to measure Toxoplasma antibodies, screen for thyroid hormones and autoantibodies, and encourage gynecologist visits to reduce the risks to mothers and fetuses.