The Silent Threat of TORCH Infections

Did you know that certain infections can silently endanger pregnancies? The TORCH acronym stands for Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV), and Hepatitis B virus (HBV), and these pathogens pose serious risks to women of reproductive age, particularly before conception. These infections account for 2-3% of all congenital anomalies worldwide, making it paramount to test for them before pregnancy.

Understanding Toxoplasma gondii Transmission

Toxoplasma gondii, a parasite capable of infecting most warm-blooded animals, including humans, is primarily transmitted through contaminated food and water, or undercooked meat. This insidious pathogen can wreak havoc on fetal development, leading to issues like hydrocephalus and intracranial calcifications when infection occurs during early pregnancy. In Iran, studies reveal that the seroprevalence among women of reproductive age ranges between 25% and 50%, reflecting local exposure risks.

The Risks of Rubella: A Preventable Concern

Rubella is a vaccine-preventable viral illness that becomes particularly dangerous when contracted during the first trimester. It can cause congenital rubella syndrome (CRS), resulting in serious disabilities. While national vaccination programs have reduced risks, immunity gaps persist among women of childbearing age. Since the rubella vaccine was introduced in Iran in 2003, some cohorts still show low immunity before conception.

Cytomegalovirus: The Hidden Viral Epidemic

Cytomegalovirus is the leading cause of congenital viral infections worldwide. Although most infections are asymptomatic in healthy adults, maternal infection can lead to severe fetal outcomes, including hearing loss and developmental delays. Worryingly, in some developing countries, CMV seropositivity rates exceed 90% by early adulthood, emphasizing the need for preventive measures.

Hepatitis B: A Chronic Public Health Challenge

Hepatitis B continues to be a serious public health issue, especially where the infection is endemic. Maternal HBV can lead to chronic infections in newborns, dramatically increasing their lifetime risk of severe liver disease. Although Iran has made strides with immunization programs, many women of reproductive age remain unvaccinated.

The Crucial Need for Preconception Screening

Despite the availability of effective vaccines and preventive measures, many women still enter pregnancy unaware of their serological status, risking vertical transmission of TORCH infections. Screening prior to conception can enable timely vaccinations and health education, significantly improving maternal and neonatal health outcomes.

New Findings from Tabriz: Safeguarding Future Generations

A recent study in Tabriz, Iran, assessed seroprevalence of antibodies against these pathogens among women of reproductive age. The results showed an alarming IgG seropositivity rate of 28.4% for T. gondii but impressively high rates for rubella (95.6%) and CMV (99.7%). However, the prevalence of IgM antibodies was worryingly low, indicating recent infections are rare, which is good news but should not lead to complacency.

Emphasizing Public Health Interventions

To further protect future generations, public health interventions are essential. Recommended measures include routine screening for T. gondii, rubella booster vaccinations for seronegative women, and incorporating TORCH panel testing into preconception care.

Conclusion: A Call to Action for Maternal Health

In summary, addressing TORCH infections can dramatically improve fertility outcomes for women in Iran and beyond. By investing in preconception health strategies, we can work to ensure safer pregnancies and healthier babies. The future of maternal and neonatal health hinges on proactive measures, and the time to act is now!