| Abstract |
Background: Congenital infections pose a major threat to the developing fetus. The presence of prenatal screening during pregnancy, carries a key role in the elimination of the vertically transmitted pathogens and consequent infections. Knowing the seroprevalence of these pathogens in the general population and emphasizing on specific high-risk groups, such as immigrants, is essential for developing a targeted public health plan.
Methods: Serologic and demographic data of all pregnant women giving birth from January 2018 to December 2018 in the University Hospital of Heraklion, was collected. Seroprevalence for HBV, HCV, HIV, CMV, Toxoplasma gondii, rubella and syphilis, was estimated and results were correlated among ethnic and age groups.
Results: A total of 659 medical records of pregnant women were studied, based on their prenatal screening panel. The mean age of the participants was 30,4 ± 6,3 years. Based on the recorded nationality of the data retained in patient files, women were separated by frequency and proximity criteria into 4 major categories. The first category consists only of those considered with Greek citizenship (n = 549, 83.3% of the sample). The second category concerns women from the Balkan region (Albania, Bulgaria, Romania) and represents 11.9% of the sample (n = 78). The third category concerns women from the rest of Europe (n = 9, 1.5%), while the fourth women from the rest of the world (n = 23, 3.8%). In the second category, the most frequently reported ethnicity was Albanian with 46 women (7.0% of the sample, 59.0% of the category), while Bulgaria recorded 19 women (2.9% of the sample, 24.4% of the sample category). In the fourth category, Syrian citizenship had 10 women (1.5% of the sample, 43.5% of the category).The mean seroprevalence of the whole study population was 0,81% for HBV, 0.5% for HCV, 0,3% for HIV, 0 % for syphilis, 18,5% for Toxoplasma, 67.3% for CMV, and 91.3% for rubella. The percentage of Greek women that tested positive for HBsAg, was 0.4%, while Albanian women, had a higher seroprevalence of 4.7%. HCV seroprevalence, respectively, in Greek women was 0.58%, while there was no other positive result among the rest of the pregnant women of this study. There was no positive result, recorded, for syphilis. The mean seroprevalence for Toxoplasma among Greek women, was 18,5%, placing the majority of them at risk of an infection, but with a low seroconversion rate, 0,3%. CMV seropositivity was estimated at 67.3% with 3.5% seroconversion rate respectively. Rubella immunity status was documented in 88% of pregnant women, revealing a seroprevalence as high as 91,3%. Screening for Toxoplasma was performed in the majority of pregnant women included in this study, but there were no congenital infections confirmed during that year.
Conclusions: The seroprevalence of HBV, remains considerably lower in Greek women than in those with Albanian origin. Toxoplasma gondii seroprevalence is recorded low, placing the majority of them at risk of an infection during pregnancy, whilst CMV seropositivity is significantly higher, providing some protection to that vulnerable group. Appropriate screening tests for HBV, HCV, HIV, toxoplasma, were performed in the majority of pregnant women, including noticeably improved percentage of syphilis screening as well. Likewise, CMV screening seems to be almost universal by obstetricians, financially burdening the health system, although both seroconversion rate and verified congenital infection were minimal during the study period.
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