بررسی ارتباط پارگی زودرس پرده‌های جنینی و ابتلاء به توکسوپلاسما گوندی در زنان باردار با زایمان زودرس

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

2 استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

3 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

4 استادیار گروه آمار، دانشکده پیراپزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

چکیده

مقدمه: ابتلاء به توکسوپلاسموزیس در بارداری دارای عوارض بالینی شامل سقط‌های خود به خودی، زایمان زودرس، مرده‌زایی و ناهنجاری‌های جنینی است. با توجه به اینکه پارگی زودرس پرده‌ها عامل اصلی زایمان زودرس می‌باشد، لذا مطالعه حاضر با هدف بررسی ارتباط ابتلاء به این انگل و پارگی زودرس پرده‌های جنینی انجام شد.
روش‌کار: این مطالعه مورد- شاهدی در سال 1395 بر روی 150 مادر باردار که جهت زایمان به بیمارستان امام خمینی اهوازمراجعه کرده بودند، انجام شد. 50 مادر باردار با زایمان زودرس و پارگی زودرس پرده‌های جنینی به عنوان گروه مورد و 100 زن باردار با زایمان زودرس و پرده‌های جنینی سالم (پس از تکمیل پرسشنامه و معاینه) به عنوان گروه شاهد انتخاب شدند. آنتی‌بادی IGG و IGM ضد توکسوپلاسما به روش الیزا در مادران دو گروه اندازه‌گیری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم افزار آماری SPSS (نسخه 21) و آزمون‌های کای دو، رگسیون لوجستیک، تی مستقل و آزمون من ویتنی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها:وجود آنتی‌بادی توکسوپلاسما IGG در زنان باردار با زایمان زودرس و بدون پارگی پرده‌های جنینی 51% و آنتی‌بادی IGM در این گروه 3% بود. مقادیر فوق در زنان باردار با زایمان زودرس 42% و با پارگی پرده‌های جنینی 4% بود. بر اساس آزمون کای دو، ارتباط معنی‌داری میان پارگی پرده‌های جنینی و ابتلاء به توکسوپلاسموزیس وجود نداشت (05/0p˃).
نتیجه‌گیری:این مطالعه نشان داد که میان آلودگی با توکسوپلاسما و پارگی زودرس پرده‌های جنینی ارتباطی وجود ندارد. بنابراین تأثیر توکسوپلاسما در ایجاد زایمان زودرس احتمالاً با مکانیسم‌هایی غیر از پارگی زودرس پرده‌های جنینی می‌باشد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between premature rupture of membrane and toxoplasma gondii infection in pregnant women

نویسندگان [English]

  • Kobra Shamakhteh 1
  • mojgan Javadnoori 2
  • Yalda Jafarideh 3
  • Amal Saki 4
1 MSc Student, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2 Associate professor, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3 Professor, Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
4 Assistant Professor, School of Paramedics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
چکیده [English]

Introduction: Toxoplasmosis during pregnancy has some clinical complications including spontaneouse abortions, preterm labor, still birth and fetal anomaly. Since premature rupture of membrane (PROM) is the major factor in preterm labor (PTL), this study was performed with aim to determine the relationship between premature rupture of membrane and toxoplasma gondii infection in pregnant women.
Methods: This case-control study was carried out on 150 pregnant women referred to Ahwaz Emam Khomeini hospital for delivery in 2016. 50 pregnant women with preterm labor and premature rupture of membranes were selected as case group and 100 pregnant women with preterm labor and healthy membranes (after completing the questionnaire and examination) were selected as control group. Anti Toxoplasma IgG and IgM antibody was measuresd by ELISA in two groups. Analysis of data was performed by statistical software SPSS (version 21) and Chi-square, logistic regression, independent t-test and Mann-Whitney test. PResults: In women with preterm labor and without rupture of membranes, 51% were positive for Toxoplasma IgG antibody and 3% for Toxoplasma IgM antibody.  The above value was 42% in pregnant women with PTL and 4% in pregnant women with PROM. Chi-square test showed no significant difference between rupture of membranes and Toxoplasmosis (P>0.05).
Conclusion: This study showed no relationship between Toxoplasma gondii and PROM. Therefore, the effect of toxoplasmosis in PROM is possibly related to other mechanisms rather than PROM.

کلیدواژه‌ها [English]

  • Anti-toxoplasma antibody
  • Premature rupture of membrane
  • Toxoplasma
  1. Razzak AH, Wais SA, Saeid AY. Toxoplasmosis: the innocent suspect of pregnancy wastage in Duhok, Irag. East Mediterr Health J 2005; 11(4):625-32.
  2. Elsheikha HM. Congenital toxoplasmosis: priorities for further health promotion action. Public Health 2008; 122(4):335–53.
  3. Eskandarian A. Seroepidemiology of toxoplasmosis in admitted pregnant women in maternity ward of Kowsar teaching and cure center in Qazvin-2006. Iran J Med Microbiol 2009; 3(2):73-9. (Persian).
  4. Parija SC. Textbook of medical parasitology, Protozoology & Helminthology. 3rd ed. Chennai, lndia: Publishers and Distributors; 2008. P. 172-81.
  5. Sensini A. Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis. Clin Microbiol Infect 2006; 12(6):504–12.
  6. Rafiei A, Hemadi A, Amani F. Seroprevalence of Toxoplasma among girl students in Ahvaz city. Iran J Infect Trop Dis 2006; 10:35-41
  7. Aali BS, Harandi F, Nazari E, Salari Z. Comparison of toxoplasma gondii IgG and IgM seropositivity between women with spontaneous abortions and ongoing pregnancies. Iran J Obstet Gynecol Infertil 2011; 14(1):1-6. (Persian).
  8. Jones JL, Kruszon-Moran D, Sanders-Lewis K, Wilson M. Toxoplasma gondii infection in the United States, 1999 2004, decline from the prior decade. Am J Trop Med Hyg 2007; 77(3):405-10.
  9. Messier V, Lévesque B, Proulx JF, Rochette L, Libman MD, Ward BJ, et al. Seroprevalence of Toxoplasma gondii among Nunavik Inuit (Canada). Zoonoses Public Health 2009; 56(4):188-97.
  10. Silva MG, Câmara JT, Vinaud MC, Castro AM. Epidemiological factors associated with seropositivity for toxoplasmosis in pregnant women from Gurupi, State of Tocantins. Brazil Rev Soc Bras Med Trop 2014; 47(4):469-75.
  11. Saleh AM, Ali Ha, Ahmed SA, Hosny SM, Morsy TA. Screening of Toxoplasma gondii infection among childbearing age females and assessment of nurses' role in prevention and control of toxoplasmosis. J Egypt Soc Parasitol 2014; 44(2):329-42.
  12. Ndiaye D, Ndiaye A, Sene PD, Ndiaye JL, Faye B, Ndir O. Evaluation of serological tests of toxoplasmosis in pregnant women realized at the Laboratory of Parasitology and Mycology of Le Dantec Teaching Hospital in 2002. Dakar Med 2007; 52(1):58­61.
  13. Gencer M, Cevizci S, Saçar S, Vural A, Cakır Güngör AN, Uysal A, et al. Evaluation of anti-Toxoplasma gondii antibody distribution and risk factors among pregnant women admitted to obstetrics polyclinic of Canakkale Onsekiz Mart University Hospital. Turkiye Parazitol Derg 2014; 38(2):76-80.
  14. Gebremedhin EZ, Abebe AH, Tessema TS, Tullu KD, Medhin G, Vitale M, et al. Seroepidemiology of Toxoplasma gondii infection in women of child-bearing age in central Ethiopia. BMC Infect Dis 2013; 13:101.
  15. Gollub EL, Leroy V, Gilbert R, Chene G, Wallon M. Effectiveness of health education on Toxoplasma-related knowledge, behaviour, and risk of seroconversion in pregnancy. Eur J Obstet Gynecol Reprod Biol 2008; 136(2):137–45.
  16. Remington JS, Mcleod R, Thulliez P. Toxoplasmosis. In: Remington JS, Klein JO, editors, Infectious disease of the fetus and newborn infant. Philadelphia: Saunders; 2006. P. 947–1092.
  17. Svadkouhi R, Izadpanah F, Zarghami A, Rajabi M, Pournasrolah M. Seroprevalence of toxoplasmosis in reproductive age women in Babol. Iran J Infect Dis 2013; 18(61):55-9. (Persian).
  18. Noorbakhsh S, Memari F, Farhadi M, Tabatabaei A. Sensorineural hearing loss due to Toxoplasma gondii in children: a case–control study. Clin Otolaryngol 2008; 33(3):269–73.
  19. Sotoode Jahromi AA. Anti-Toxoplasma antibodies in women with abortion or still birth. Pars J Med Sci 2007; 4(4):47-52. (Persian).
  20. Ebadi P, Yaghobi R, Eftekhar F, Bagheri K. Seroprevalence of CMV and Rubella in women with recurrent spontaneous abortion in comparison with normal delivery. J Fasa Univ Med Sci 2011; 1(3):136-41.
  21. Maraghi S, YadYad MJ, Sheikhi M, Latifi SM. Frequency of anti-toxoplasma antibodies in midwifery and nursing students of Abadan Islamic Azad University Students in 2011. Armaghane Danesh 2013; 18(4):327-36. (Persian).
  22. Sohrabi A, Samarbaf A, Makvandi M, Maraghi S, Razi T, Darban D. A seroepidemiological study of parvovirus B19, Toxoplasma gondii and Chlamydia trachomatis in pregnant women referring to Obs & Gyn ward of Ahwaz Imam Khomeini Hospital. J Reprod Infertil 2007; 2(8):171-5.
  23. Hajsoleimani F, Ataeian A, Nourian A, Mazloomzadeh S. Seroprevalence of Toxoplasma gondii in pregnant women and bioassay of IgM positive cases in Zanjan, Northwest of Iran. Iran J Parasitol 2012; 7(2):82-6.
  24. Alimohammadi H, Fouladi N, Amani F, Safarzade M, Pourfarzi F, Mazaheri E. Sero epidemiological toxoplasmosis in pre marriage women on the basis of remarriage tests 2007. J Ardabil Univ Med Sci 2009; 8(4):408-13.
  25. Fauci AS. Harrison's principles of internal medicine. 17th ed. New York: McGraw-Hill, Medical Publishing Division; 2008.
  26. Pinard JA, Leslie NS, lrvine PJ. Maternal serologic screening for toxoplasmosis. J Midwifery Womens Health 2003; 48(5):308-16.
  27. Singh S. Mother-to-child transmission and diagnosis of Toxoplasma gondii infection during pregnancy. Indian J Med Microbiol 2003; 21(2):69-76.
  28. Zhang SF, Song RH. Toxoplasma gondii infection status in abnormal pregnancy women. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2014; 26(4):437-8.
  29. Saeedi M, Bakhshandeh Nosrat S, Moradi A, Hedayat Mofidi SM, Behnampoor N. Comparative study of cytomegalovirus, listeria monocytogen and Toxoplasma gondii infections in successful and non-successful pregnancy in Gorgan. Med Lab J 2009; 3(1):25-30.
  30. Saraei-Sahnesaraei M, Shamloo F, Jahani Hashemi H, Khabbaz F, Alizadeh SA. Relation between Toxoplasma gondii infections and schizophrenia. Iran J Psychiat Clin Psychol 2009; 15(1):3-9.
  31. Breeze AC, Aiexander PM, Murdoch EM, Missfelder-Lobos HH, Hackett GA, Less CC. Obstetric and neonatal outcomes in severe fetal ventriculomegaly. Prent Diagn 2007; 27(2):124-9.
  32. Adrysyan GH, Rezaeian M, Ghorbani M, Keshavarz H, Mhbly M. Medical protozoology. 1st ed. Tehran: Tehran University of Medical Sciences; 2007. P. 151-2.
  33. Belfort RN, Singh AD. Basic and clinical science course section 4: ophthalmic pathology and intraocular tumors. San Francisco, CA: American Academy of Ophthalmology; 2009. P. 146.
  34. World Health Organization. Born too soon: the global action report on preterm birth. Geneva: World Health Organization; 2012. P. 7.
  35. Cunningham FG, Levono KJ, Bloom SL, Hauth JC, Rouse DJ, Sponge CY. Williams Obstetrics. 23rd ed. New York: McGraw Hill; 2010. P. 1016-7, 1022-4.
  36. Sadler TW. Langman's medical embryology. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2011.
  37. Jones JL, Dargelas V, Roberts J, Press C, Remington JS, Montoya JG. Risk factors for Toxoplasma gondii infection in the United States. Clin Infect Dis 2009; 49(6):878-84.
  38. Lopes FM, Mitsuka-Bregano R, Goncalves DD, Freire RL, Karigyo CJ, Wedy GF, et al. Factors associated with seropositivity for anti-Toxoplasma gondii antibodies in pregnant women of Londrina, Parana, Brazil. Mem Inst Oswaldo Cruz 2009; 104(2):378-82.
  39. Ebrahimzadeh A, Mohammadi S, Salimi-Khorashad A, Jamshidi A. Seroprevalence of Toxoplasmosis among pregnant women referring to the reference laboratory of Zahedan, Iran. Med Lab J 2013; 7(3):61-8
  40. Zemene E, Yewhalaw D, Abera S, Belay T, Samuel A, Zeynudin A. Seroprevalence of Toxoplasma gondii and associated risk factors among pregnant women in Jimma town, Southwestern Ethiopia. BMC Infect Dis 2012; 12:337.
  41. Fouladv M, Barazesh A, Naeimi B, Zandi K, Tajbakhsh S. Seroprevalence of toxoplasmosis in high school girls in Bushehr city South-west of Iran, 2009. Afr J Microbiol Res 2010; 4(11):1117-21.
  42. Ryan KJ, Berkowitz RS, Barbieri RL, Dunaif A. Kistner's gynecology and women's health. 7th ed. New York: Mosby Incorporated; 2008.
  43. Novak E. Berek and Novak's Gynecology. 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
  44. Holschneider CH, Berek JS. Vulvar cancer. In: Novak E, editor, Berek and Novak's Gynecology. 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. P. 503.