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Identifier

000414892

Title

Seroprevalence of perinatal infections among pregnant women in Crete

Alternative Title

Ορολογικός έλεγχος για συγγενείς λοιμώξεις σε εγκύους στην Κρήτη

Author

Αναγνωστάτου, Νικολίνα -Χίλντα

Thesis advisor

Γαλανάκης, Εμμανουήλ
Μακρυγιαννάκης, Αντώνης
Παπαευαγγέλου, Βάνα

Abstract

Background: Vertical transmission of infections during pregnancy can have deleterious consequences for the developing fetus. Focused prenatal screening and appropriate treatment of the pregnant woman or the neonate is of paramount importance in the struggle for the elimination of congenital infections. Exact knowledge of the seroprevalence of the infectious agents, with special attention to specific high-risk groups, such as immigrants, is necessary for proper public health planning. Methods: Demographic and serologic data ofall pregnant women delivering from January 2017 to December 2017 in the three major public hospitals in Crete (University Hospital of Heraklion, Venizeleio General Hospital of Heraklion, and "Ag.Georgios" General Hospital of Chania) were collected. Seroprevalence was estimated for HBV, HCV, HIV, syphilis, Toxoplasma gondii, CMV, and rubella. Results were compared among ethnic groups and according to age stratification. Results: A total of 1912 medical records of pregnant women were studied based on their prenatal screening panel. The mean age of the participants was 30.38 (± 6) years. Their origin was Greek (77.2 %), Albanian (22.7%), Bulgarian (3.3%), Romanian (1.7%), East Asian (0.4%), refugees from Syria, Maroco, Egypt (0.7%), former Republics of Russia (1.9%), Roma population (2%), Central/Western Europe (0.7%)and 1.1% with unknown country of origin. The mean seroprevalence of the whole study population was 1.5% for HBV, 0.43% for HCV, 0% for HIV, 0.22% for syphilis, 21.7% for Toxoplasma, 69.1% for CMV, and 87.9% for rubella. The seroprevalence of Greek women for HBV was 0.5%, while Albanian women, Bulgarian, Romanian and Roma had a high seroprevalence of 4.3%, 5.7%, 2.8%, and 4 Faculty of Medicine - University of Crete 11.1% respectively (p<0.001). Similar results were found for HCV; seroprevalence in Greek women 0.1%, in Bulgarian 1.4%, Roma 4.4%, and former Soviet Union 5.3%. Syphilis was recorded only in 2 patients of Romanian origin. The mean seroprevalence for Toxoplasma was 21.7%, placing Greece in an intermediate endimicity category, while CMV seropositivty was estimated at 69.1%. The seroconversion rate for Toxoplasma was 4% and for CMV 3.4%. Rubella immunity was documented in 84.2% of pregnant women. Women were properly screened in the majority of cases against HBV, HCV, and HIV, but syphilis screening was omitted in >50% of cases. Screening for Toxoplasma and CMV was performed in the majority of cases, but no congenital infections were confirmed throughout the year. Conclusions: The seroprevalence of HBV, HCV and syphilis is much lower in Greek women than in foreign women of east European or east Asian origin. Toxoplasma gondii seroprevalence is low in Crete, putting women at a high risk for being infected during pregnancy, while CMV seropositivity is much higher, conferring a level of protection to the population. Prenatal screening of pregnant women in Greece is performed at a good level, providing screening for HBV, HCV, and HIV to the majority of women, while syphilis screening needs to be optimized. CMV and toxoplasma are screened almost universally by obstetricians, placing a big economic burden on the health system, even though the seroconversion rates are low and no congenital infection was verified during the study period.

Language

Greek

Subject

CMV

Childbearing age

Congenital infection

Epidemiology

HBV

HCV

HIV

Perinatal infection

Rubella