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关于弓形虫感染的母婴及生殖系统疾病的最新文献综述。

An updated literature review on maternal-fetal and reproductive disorders of Toxoplasma gondii infection.

作者信息

Fallahi S, Rostami A, Nourollahpour Shiadeh M, Behniafar H, Paktinat S

机构信息

Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, 68138-33946 Khorramabad, Iran.

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, 47176-47745 Babol, Iran.

出版信息

J Gynecol Obstet Hum Reprod. 2018 Mar;47(3):133-140. doi: 10.1016/j.jogoh.2017.12.003. Epub 2017 Dec 8.

Abstract

BACKGROUND

Toxoplasma gondii infection is one of the most prevalent infectious disease with worldwide distribution. Congenital toxoplasmosis is annually responsible for 1.20 million disability-adjusted life years around the world, but often it is overlooked many countries.

METHODS

We performed an updated review to summarize the current researches on fetal, neonatal and maternal consequences of T. gondii infection and also adverse effects of toxoplasmosis on women reproductive organs.

RESULTS

T. gondii infection could be cause of several abnormalities from hydrocephalus, microcephaly, deafness, abortion and still birth in fetal to psychomotor retardation, intellectual disability, hearing loss, slower postnatal motor development during the first year of life; and chorioretinitis, cryptogenic epilepsy and autism spectrum disorders in newborns. Moreover, this infection is related with neuropsychiatric disorders such as anxiety, schizophrenia spectrum disorders, depression, decreased weight, autoimmune thyroid diseases, self-directed violence, violent suicide attempts in mothers. This literature review emphasized that toxoplasmosis could be an important neglected factor endometritis, ovarian dysfunction, impaired folliculogenesis, ovarian and uterine atrophy, decrease in reproductive organs weight and reproductive performance in women. We reviewed role of the immunological profile such as pro-infiammatory cytokines and hormonal changes as main potential mechanisms related to this infection and development of maternal-fetal and reproductive disorders.

CONCLUSION

T. gondii is associated with several brain related disorders in both mothers and newborns, and also it is cause of several abnormalities in reproductive organs. Early diagnosis and treatment of the infection could be effective to significantly improve the clinical outcome.

摘要

背景

弓形虫感染是全球分布最为广泛的传染病之一。先天性弓形虫病每年在全球导致120万个伤残调整生命年,但在许多国家往往被忽视。

方法

我们进行了一项更新综述,以总结当前关于弓形虫感染对胎儿、新生儿和母亲的影响以及弓形虫病对女性生殖器官的不良影响的研究。

结果

弓形虫感染可能导致多种异常,从胎儿的脑积水、小头畸形、耳聋、流产和死产到出生后第一年的精神运动发育迟缓、智力残疾、听力损失、运动发育迟缓;以及新生儿的脉络膜视网膜炎、隐源性癫痫和自闭症谱系障碍。此外,这种感染与母亲的神经精神疾病有关,如焦虑、精神分裂症谱系障碍、抑郁症、体重减轻、自身免疫性甲状腺疾病、自我导向暴力、暴力自杀企图。这篇文献综述强调,弓形虫病可能是女性子宫内膜炎、卵巢功能障碍、卵泡发生受损、卵巢和子宫萎缩以及生殖器官重量和生殖性能下降的一个重要被忽视因素。我们综述了免疫谱如促炎细胞因子和激素变化作为与这种感染以及母婴和生殖障碍发展相关的主要潜在机制的作用。

结论

弓形虫与母亲和新生儿的几种脑部相关疾病有关,也是生殖器官多种异常的原因。感染的早期诊断和治疗可能有效地显著改善临床结局。

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