Published: 2020-12-26

Seroprevalence rates of Toxoplasma gondii, Rubella, Cytomegalovirus among first trimester pregnant women in Istanbul

Aysegul Ozer, Mujde Canday, Aslihan Yurtkal, Ebru Alici Davutoglu, Yasam Kemal Akpak, Dogay Nurtac Ozmus, Alper Ileri, Adnak Budak, Riza Madazli


Background: Toxoplasma Gondii, Rubella, and Cytomegalovirus (CMV) are the most common causes of congenital infections worldwide. There is not a consensus on these infectious agents should be screened during pregnancy. The aim of this study is to determine the prevalence of toxoplasma, rubella, and CMV infections in order to know the need for antenatal screening.

Methods: This retrospective cross-sectional study was performed on 1309 ambulatory pregnant patients who applied to the obstetric clinic of a university hospital between October 2016 and April 2018. Documents of patients in the first trimester were reviewed and serologic data of Toxoplasma gondii, CMV, Rubella infections were retrieved from the computer database.

Results: Of 1309 pregnant women, positivity for anti-Toxoplasma IgG antibody was 352(26.9%), while 17(1.3%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody. These positivities of the pregnant women for anti-Rubella IgG and IgM were 1147(87.6%) and (0.1%), respectively. These positivities of the pregnant women for anti-CMV IgG and IgM were 1163(88.8%) and 17(1.3%), respectively.

Conclusions: We detected high rates of immunity against Rubella and CMV but low rates of immunity against Toxoplasma in this retrospective cohort of pregnant women. Due to high rates of seropositivity against Rubella and CMV, routine nationwide screening may not be necessary.


Cytomegalovirus, Maternal infection, Prenatal infection, Rubella, Toxoplasma

Full Text:



Vergnano S, Heath PT. Fetal and neonatal infections. Med. 2013;41:723–29.

Many A, Koren G. Toxoplasmosis during pregnancy. Can Fam Physician. 2006;52: 29-0.

Leeper C, Lutzkanin A. Infections During Pregnancy. Prim Care Clin Office Pract. 2018;45:567-86.

Cannon MJ, Davis KF. Washing our hands of the congenital cytomegalovirus disease epidemic. BMC Pub Health. 2005;5:70.

Prasoona KR, Srinadh B, Sunitha T, Sujatha M, Deepika MLN, Vijaya Lakshmi B, et al. Seroprevalence and Influence of Torch Infections in High-Risk Pregnant Women: A Large Study from South India. The J Obst Gynecol India. 2015;65:301–09.

Kieffer F, Wallon M. Congenital toxoplasmosis. Handb Clin Neurol. 2013;112:1099–101.

SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group, Thie ́baut R, Leproust S, Chene G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007;369:115–22.

Pappas G, Roussos N, Falagas ME. Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol. 2009;39:1385-94.

Harma M, Gungen N, Demir N. Toxoplasmosis in pregnant women in Sanlıurfa. Southeastern Anatolia City, Turkey. J Egypt Soc Parasitol. 2004;34:519–25.

Ocak S, Zeteroglu S, Ozer C, Dolapcıoglu K, Gungoren A. Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in Southern Turkey. Scand J Infect Dis. 2007;39:231–34.

Kolgelier S, Demiraslan H, Kataş B, Guler D. Seroprevalence of toxoplasma gondii in pregnant women. Dicle Med J. 2009;36:170–72.

Bakacak M, Bostancı MS, Kostu B, Ercan O, Serın S, Avcı F, et al. Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women. Dicle Med J. 2014;41:326–31.

Toklu DG. Antibodies frequency against toxoplasmosis, rubella virus, and cytomegalovirus in pregnant women. J Clin Anal Med. 2013;4:38–0.

Doğan K, Güraslan H, Ozel G, Aydan Z, Yaşar L. Seroprevalence rates of Toxoplasma gondii, rubella, cytomegalovirus, syphilis, and hepatitis B, seroprevalences rate in the pregnant population in Istanbul. Turkiye Parazitol Derg. 2014;38:228-33.

Karacan M, Batukan M, Cebi Z, Berberoglugil M, Levent S, Kır M, et al. Screening cytomegalovirus, rubella, and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet. 2014;290(6):1115-120.

Keskin DD, Keskin S. Toxoplasma, Rubella, CMV. HBV, anti-Hbs, HCV, HIV seroprevalence in first-trimester pregnant women. Selcuk Med J. 2013;29:123–6.

Numan O, Vural F, Aka N, Alpay M, Coskun AD. TORCH seroprevalence among patients attending Obstetric Care Clinic of Haydarpasa Training and Research Hospital affiliated to the Association of Istanbul Northern Anatolia Public Hospitals. North Clin Istanb. 2015;2:203-09.

Di Mario S, Basevi V, Gagliotti C, Spettoli D, Gori G, D'Amico R, et al. Prenatal education for congenital toxoplasmosis. Coch Data Syst Rev. 2015(10).

Neu N, Duchon J, Zachariah P. TORCH infections. Clinics in perinatology. 2015;42(1):77-103.

Karakas A, Türker T, Arslan E, Turhan V. Investigation of Rubella susceptibility rate among women of childbearing age in a private medical center, Van province, Turkey. Tür Hij Deney Biyol Dergisi. 2010;67:179-84.

Kolgelier S, Demiraslan H, Kataş B, Guler D. Seroprevalence of Toxoplasma gondii in Pregnant Women. Dicle Med J. 2009;36:170–72.

Varol FG, Sayin NC, Soysuren S. Seroprevalence of Toxoplasma gondii antibodies in an antenatal population of the Trakya region. J Turk Soc Obstet Gynecol. 2011;8:93–9.

Gindes L, Teperberg-Oikawa M, Sherman D, Pardo J, Rahave G. Congenital cytomegalovirus infection following primary maternal infection in the third trimester. BJOG. 2008;115:830–35.

Aynioglu A, Aynioglu O, Altunok ES. Seroprevalence of Toxoplasma gondii, rubella and Cytomegalovirus among pregnant females in north-western Turkey. Acta Clinica Belgica. 2015;70(5):321-4.

Picone O, Vauloup-Fellous C, Cordier AG, Parent Du Chátalet, Senat M, Frydman R, et al. A 2- year study on cytomegalovirus infection during pregnancy in a French hospital. BJOG. 2009;116:818-23.

Alanen A, Kahala K, Vahlberg T, Koskela P, Vainionpää R. Seroprevalence, the incidence of prenatal infections and reliability of maternal history of varicella-zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in South-Western Finland. BJOG. 2005;112:50-6.

Aljumaili ZKM, Alsamarai AM, Najem WS. Cytomegalovirus seroprevalence in women with bad obstetric history in Kirkuk, Iraq. J Infect Pub Heal. 2014;7:277-88.

Gun I, Ertugrul S, Kaya N, Akpak YK. Seroprevalence among Turkish pregnant women. Health MED. 2012;6(7):2471-76.