Frequency of risk infections for congenital infection in pregnant women

Heriberto Caballero-Ortega, Luz Belinda Ortiz-Alegría, Ana Laura Castañeda-Huitrón, Chiharu Murata, Ricardo Figueroa-Damián, María Dolores Correa Beltrán


BACKGROUND: TORCH and other infections can be vertically transmitted and provoke abortions or result in congenitally infected newborns. Most babies are born with subclinical infection but have a high risk of developing sequalae later.

OBJECTIVE: To determine the frequency of seven endemic infections that represent risk for vertical transmission among pregnant women of a tertiary care hospital.

MATERIALS AND METHODS: Prospective, cross-sectional study carried out in pregnant women attended at the INPer between 2010 and 2012. Infections were investigated by serological risk markers among pregnant women living in the Valley of Mexico and answered a questionnaire including risk factors.

RESULTS: A total of 1079 pregnant women were studied, and the overall frequency of infection was 5.7%. Anti-Toxoplasma gondii low avidity IgG (2.0%) and parvovirus B19 IgM (2.0%) were the most common. No HBV S-Ag and one rubella case were detected. An association of markers studied with fetal malformations and transfusions (p < 0.015) was found. Toxoplasma infection was associated with the last two variables, as well as with the consumption of raw meat, previous positive TORCH and infection with HPV. Parvovirus B19 IgM was associated with stillbirths, and T. pallidum with HIV. Four cases had double infections.

CONCLUSIONS: This study supports the success of vaccination control programs against rubella and active HBV, although infections or perinatal risk are still challenging for this group of women and their children´s health.

Texto completo:

PDF (English)


Correa D, Figueroa-Damián R. Infecciones congénitas y perinatales. Una visión integral. 1st ed. CDMX: Médica Panamericana; 2014.

Neu N, Duchon J, Zachariah P. TORCH infections. Clin Perinatol. 2015;42(1):77-103. DOI: 10.1016/j.clp.2014.11.001.

Madrid L, Varo R, Sitoe A, Bassat Q. Congenital and perinatally-acquired infections in resource-constrained settings. Expert Rev Anti Infect Ther. 2016;14(9):845-61. DOI: 10.1080/14787210.2016.1215913.

Leruez-Ville M, Ville Y. Fetal cytomegalovirus infection. Best Pract Res Clin Obstet Gynaecol. 2017;38:97-107. DOI: 10.1016/j.bpobgyn.2016.10.005.

Hahn HS, Kee MK, Kim HJ, Kim MY, Kang YS, Park JS, et al. Distribution of maternal and infant human papillomavirus: risk factors associated with vertical transmission. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):202-6. DOI: 10.1016/j.ejogrb.2013.02.024.

Ville Y, Leruez-Ville M. Managing infections in pregnancy. Curr Opin Infect Dis. 2014;27(3):251-7. DOI: 10.1097/QCO.0000000000000066.

Grant GB, Reef SE, Dabbagh A, Gacic-Dobo M, Strebel PM. Global progress toward rubella and congenital rubella syndrome control and elimination - 2000-2014. MMWR Morb Mortal Wkly Rep. 2015;64(37):1052-5. DOI: 10.15585/mmwr.mm6437a5.

Shih C, Chou SF, Yang CC, Huang JY, Choijilsuren G, Jhou RS. Control and eradication strategies of hepatitis B virus. Trends Microbiol. 2016;24(9):739-49. DOI: 10.1016/j.tim.2016.05.006.

Noyola DE, Mejía-Elizondo AR, Canseco-Lima JM, Allende-Carrera R, Hernández-Salinas AE, Ramírez-Zacarías JL. Congenital cytomegalovirus infection in San Luis Potosí, Mexico. Pediatr Infect Dis J. 2003;22(1):89-90. DOI: 10.1097/00006454-200301000-00022.

Noyola DE, Malacara-Alfaro O, Lima-Rogel V, Torres-Montes A. Seroprevalence of syphilis in pregnant women in San Luis Potosí. Salud Publica Mex. 2006;48(2):151-4. DOI: 10.1590/s0036-36342006000200008.

Vázquez-Martínez JL, Coreño-Juárez MO, Montaño-Estrada LF, Attlan M, Gómez-Dantés H. Seroprevalence of hepatitis B in pregnant women in Mexico. Salud Publica Mex. 2003;45(3):165-70. DOI: 10.1590/s0036-36342003000300005.

Yañez-Alvarez I, Conde-González CJ, Uribe-Salas FJ, Olamendi-Portugal ML, García-Cisneros S, Sánchez-Alemán MA. Maternal/child seroprevalence of antibodies against Treponema pallidum at four general hospitals in the state of Morelos, Mexico. Arch Med Res. 2012;43(7):571-7. DOI: 10.1016/j.arcmed.2012.10.001.

Alvarado-Esquivel C, Hernández-Tinoco J, Sánchez-Anguiano LF, Ramos-Nevárez A, Cerrillo-Soto SM, Estrada-Martínez S, et al. Seroepidemiology of cytomegalovirus infection in pregnant women in Durango City, Mexico. BMC Infect Dis. 2014;14:484. DOI: 10.1186/1471-2334-14-484.

Alvarado-Esquivel C, Hernandez-Tinoco J, Sanchez-Anguiano LF, Ramos-Nevarez A, Cerrillo-Soto SM, Salas-Pacheco JM, et al. Rubella immune status in pregnant women in a Northern Mexican City. J Clin Med Res. 2016a;8(9):656-661. DOI: 10.14740/jocmr2635w.

Alvarado-Esquivel C, Terrones-Saldívar MC, Hernández-Tinoco J, Muñoz-Terrones MD, Gallegos-González RO, Sánchez-Anguiano LF, et al. Seroepidemiology of Toxoplasma gondii in pregnant women in Aguascalientes City, Mexico: a cross-sectional study. BMJ Open. 2016b;6(7):e012409. DOI: 10.1136/bmjopen-2016-012409.

Best JM, Reef S. The immunological basis for immunization series: module 11: rubella. In: World Health Organization, editor. Immunization, Vaccines and Biologicals. Switzerland: World Health Organization; 2008. p. 1-37.

Henao-Martínez AF, Johnson SC. Diagnostic tests for syphilis: New tests and new algorithms. Neurol Clin Pract. 2014;4(2):114-22. DOI: 10.1212/01.CPJ.0000435752.17621.48.

Cañedo-Solares I, Ortiz-Alegría LB, Figueroa-Damián R, Bustos-Bahena ML, González-Henkel H, Calderón-Segura E, et al. Toxoplasmosis in pregnancy: determination of IgM, IgG and avidity in filter paper-embedded blood. J Perinatol. 2009;29(10):668-72. DOI: 10.1038/jp.2009.79.

Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. Lancet. 1999;353(9167):1829-33. DOI: 10.1016/S0140-6736(98)08220-8.

Vela-Amieva M, Cañedo-Solares I, Gutiérrez-Castrellón P, Pérez-Andrade M, González-Contreras C, Ortíz-Cortés J, et al. Short report: neonatal screening pilot study of Toxoplasma gondii congenital infection in Mexico. Am J Trop Med Hyg. 2005;72(2):142-4.

Petersen E, Vesco G, Villari S, Buffolano W. What do we know about risk factors for infection in humans with Toxoplasma gondii and how can we prevent infections? Zoonoses Public Health. 2010;57(1):8-17. DOI: 10.1111/j.1863-2378.2009.01278.x.

Rico-Torres CP, Valenzuela-Moreno LF, Luna-Pastén H, Figueroa-Damián R, Gómez-Toscano V, Hernández-Delgado L, et al. High heterogeneity, mixed infections and new genotypes in human congenital toxoplasmosis cases in the mega-metropolis of Central Mexico. Acta Trop. 2018;178:124-9. DOI: 10.1016/j.actatropica.2017.11.008.

Arce-Estrada GE, Gómez-Toscano V, Cedillo-Peláez C, Sesman-Bernal AL, Bosch-Canto V, Mayorga-Butrón JL, et al. Report of an unusual case of anophthalmia and craniofacial cleft in a newborn with Toxoplasma gondii congenital infection. BMC Infect Dis. 2017;17(1):459-63. DOI: 10.1186/s12879-017-2565-8.

Mossong J, Hens N, Friederichs V, Davidkin I, Broman M, Litwinska B, et al. Parvovirus B19 infection in five European countries: seroepidemiology, force of infection and maternal risk of infection. Epidemiol Infect. 2008;136(8):1059-68. DOI: 10.1017/S0950268807009661.

Emiasegen SE, Nimzing L, Adoga MP, Ohagenyi AY, Lekan R. Parvovirus B19 antibodies and correlates of infection in pregnant women attending an antenatal clinic in central Nigeria. Mem Inst Oswaldo Cruz. 2011;106(2):227-31. DOI: 10.1590/s0074-02762011000200018.

Barriga-Angulo G, Castillo-Torres NP, Tapia-Jamett H. La infección por Parvovirus B19 en México. Rev Mex Patol Clín. 1995;42(4):160-3.

Mancebo-Hernández A, González-Rivera A, González-Saldaña N, Lombardo-Aburto E. Estudio de un brote de infección por Parvovirus B19 en un hospital de la Ciudad de México. Acta Ped Mex. 2006;27(2):66-72.

Crane J, Mundle W, Boucoiran I, MATERNAL FETAL MEDICINE COMMITTEE. Parvovirus B19 infection in pregnancy. J Obstet Gynaecol Can. 2014;36(12):1107-16. DOI: 10.1016/S1701-2163(15)30390-X.

Indolfi G, Resti M. Perinatal transmission of hepatitis C virus infection. J Med Virol. 2009;81(5):836-43. DOI: 10.1002/jmv.21437.

Wen JW, Haber BA. Maternal-fetal transmission of hepatitis C infection: what is so special about babies? J Pediatr Gastroenterol Nutr. 2014;58(3):278-82. DOI: 10.1097/MPG.0000000000000258.

Joseph A, Mahida N, Irving W, Soo S. Congenital cytomegalovirus infection. Paed Child Health. 2014;24:255-9.

Newman L, Kamb M, Hawkes S, Gomez G, Say L, Seuc A, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med. 2013;10: e1001396. DOI: 10.1371/journal.pmed.1001396

Sánchez-Alemán MA, Conde-González CJ. Sífilis congénita. In: Correa D, Figueroa R, editors. Infecciones Congénitas y Perinatales. Una visión integral. CDMX: Médica Panamericana; 2014. p. 115-22.

Meredith S, Hawkes S, Schmid G, Broutet N. The global elimination of congenital syphilis: rationale and strategy for action. Geneva: WHO Library Cataloguing-in-Publication Data; 2007.

Santos JI. Vaccination in Mexico in the context of the "vaccine decades": achievements and challenges. Gac Med Mex. 2014;150:180-8.

Díaz-Ortega JL, Meneses-Reyes CD, Palacios-Martínez M. Incidence and transmission patterns of rubella in Mexico. Salud Publica Mex. 2007;49:337-44. DOI: 10.1590/s0036-36342007000500004

Metcalf CJ, Bjørnstad ON, Ferrari MJ, Klepac P, Bharti N, Lopez-Gatell H. Grenfell BT. The epidemiology of rubella in Mexico: seasonality, stochasticity and regional variation. Epidemiol Infect. 2011;139:1029-38. DOI: 10.1017/S0950268810002165

Boletín epidemiológico [Interntet]. Sistema Nacional de Vigilancia Epidemiológica. Sistema Único de Información. Dirección General de Epidemiología; 2019 [Accessed 20 may 2019]. Available from:


Enlaces refback

  • No hay ningún enlace refback.