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Abstract

BACKGROUND

Microbiological surveillance during pregnancy is important for better neonatal outcomes.

AIM

We aimed to assess IgG and IgM antibodies against , parvovirus B19, , rubella virus and cytomegalovirus in women of fertile age (16–45 years) in Italy and investigate factors associated with the presence of antibodies.

METHODS

We collected data from clinical microbiology laboratories on test results for IgG and IgM antibodies against , parvovirus B19, , rubella virus and cytomegalovirus between 1 July 2019 and 30 June 2020. Serological tests, like IgG avidity for and cytomegalovirus, non-treponemal tests for and molecular tests for parvovirus B19 and rubella virus were considered as confirmatory tests for acute infections. We investigated associations between presence of antibodies with age, nationality and geographic area of residence.

RESULTS

Thirty-two laboratories submitted test results on 342,095 women. The overall weighted proportion of IgG antibodies was 13,700 of 111,580 (13%; 95% confidence interval (CI): 12–14) for women tested for , 3,298 of 5,138 (65%; 95% CI: 60–69) for parvovirus B19, 63,828 of 69,865 (87%; 95% CI: 85–88) for rubella virus and 45,558 of 71,013 (66%; 95% CI: 64–68) for cytomegalovirus. For , 889 of 81,401 (1%; 95% CI: 1–1) of treponemal tests were positive. Overall, we estimated 530 acute infections with , 33 with parvovirus and 449 with cytomegalovirus.

CONCLUSION

These findings underline the need for screening for congenital infections in fertile women.

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/content/10.2807/1560-7917.ES.2026.31.4.2500135
2026-01-29
2026-02-08
/content/10.2807/1560-7917.ES.2026.31.4.2500135
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References

  1. Coyne CB, Lazear HM. Zika virus - reigniting the TORCH. Nat Rev Microbiol. 2016;14(11):707-15.  https://doi.org/10.1038/nrmicro.2016.125  PMID: 27573577 
  2. Neu N, Duchon J, Zachariah P. TORCH infections. Clin Perinatol. 2015;42(1):77-103, viii.  https://doi.org/10.1016/j.clp.2014.11.001  PMID: 25677998 
  3. Chen L, Liu J, Shi L, Song Y, Song Y, Gao Y, et al. Seasonal influence on TORCH infection and analysis of multi-positive samples with indirect immunofluorescence assay. J Clin Lab Anal. 2019;33(4):e22828.  https://doi.org/10.1002/jcla.22828  PMID: 30666721 
  4. Akyar I. Seroprevalence and coinfections of Toxoplasma gondii in childbearing age women in Turkey. Iran J Public Health. 2011;40(1):63-7. PMID: 23113056 
  5. Abu-Madi MA, Behnke JM, Dabritz HA. Toxoplasma gondii seropositivity and co-infection with TORCH pathogens in high-risk patients from Qatar. Am J Trop Med Hyg. 2010;82(4):626-33.  https://doi.org/10.4269/ajtmh.2010.09-0530  PMID: 20348511 
  6. Guimarães LM, Carneiro EL, Carvalho-Costa FA. Increasing incidence of pertussis in Brazil: a retrospective study using surveillance data. BMC Infect Dis. 2015;15(1):442.  https://doi.org/10.1186/s12879-015-1222-3  PMID: 26498058 
  7. Boyer SG, Boyer KM. Update on TORCH infections in the newborn infant. Newborn Infant Nurs Rev. 2004;4(1):70-80.  https://doi.org/10.1053/j.nainr.2004.01.001 
  8. de Jong EP, Vossen AC, Walther FJ, Lopriore E. How to use... neonatal TORCH testing. Arch Dis Child Educ Pract Ed. 2013;98(3):93-8.  https://doi.org/10.1136/archdischild-2012-303327  PMID: 23470252 
  9. Kishore J, Misra R, Paisal A, Pradeep Y. Adverse reproductive outcome induced by Parvovirus B19 and TORCH infections in women with high-risk pregnancy. J Infect Dev Ctries. 2011;5(12):868-73.  https://doi.org/10.3855/jidc.1533  PMID: 22169786 
  10. Istituto Superiore di Sanità (ISS). Gravidanza fisiologica. [Physiological pregnancy]. Rome: ISS; 23 Jun 2025. Italian. Available from: https://www.iss.it/-/gravidanza-fisiologica
  11. De Paschale M, Pavia C, Cerulli T, Cagnin D, Manco MT, Belvisi L, et al. Prevalence of anti-parvovirus B19 IgG and IgM and parvovirus B19 viremia in pregnant women in an urban area of Northern Italy. J Med Virol. 2022;94(11):5409-14.  https://doi.org/10.1002/jmv.27963  PMID: 35764590 
  12. World Health Organization (WHO). Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. Geneva: WHO; 18 Jul 2022. Available from: https://www.who.int/publications/i/item/9789240053779
  13. Leruez-Ville M, Foulon I, Pass R, Ville Y. Cytomegalovirus infection during pregnancy: state of the science. Am J Obstet Gynecol. 2020;223(3):330-49.  https://doi.org/10.1016/j.ajog.2020.02.018  PMID: 32105678 
  14. Cutts FT, Hanson M. Seroepidemiology: an underused tool for designing and monitoring vaccination programmes in low- and middle-income countries. Trop Med Int Health. 2016;21(9):1086-98.  https://doi.org/10.1111/tmi.12737  PMID: 27300255 
  15. Palazzotto E, Bonura F, Calà C, Capra G, Pistoia D, Mangione D, et al. Serological status for TORCH in women of childbearing age: a decade-long surveillance (2012-2022) in Italy. J Med Microbiol. 2023;72(7).  https://doi.org/10.1099/jmm.0.001733  PMID: 37458733 
  16. Dini FM, Morselli S, Marangoni A, Taddei R, Maioli G, Roncarati G, et al. Spread of Toxoplasma gondii among animals and humans in Northern Italy: A retrospective analysis in a One-Health framework. Food Waterborne Parasitol. 2023;32:e00197.  https://doi.org/10.1016/j.fawpar.2023.e00197  PMID: 37333686 
  17. Garnaud C, Fricker-Hidalgo H, Evengård B, Álvarez-Martínez MJ, Petersen E, Kortbeek LM, et al. Toxoplasma gondii-specific IgG avidity testing in pregnant women. Clin Microbiol Infect. 2020;26(9):1155-60.  https://doi.org/10.1016/j.cmi.2020.04.014  PMID: 32334096 
  18. Fanigliulo D, Marchi S, Montomoli E, Trombetta CM. Toxoplasma gondii in women of childbearing age and during pregnancy: seroprevalence study in Central and Southern Italy from 2013 to 2017. Parasite. 2020;27:2.  https://doi.org/10.1051/parasite/2019080  PMID: 31934847 
  19. Bigna JJ, Tochie JN, Tounouga DN, Bekolo AO, Ymele NS, Youda EL, et al. Global, regional, and country seroprevalence of Toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis. Sci Rep. 2020;10(1):12102.  https://doi.org/10.1038/s41598-020-69078-9  PMID: 32694844 
  20. van den Berg OE, Stanoeva KR, Zonneveld R, Hoek-van Deursen D, van der Klis FR, van de Kassteele J, et al. Seroprevalence of Toxoplasma gondii and associated risk factors for infection in the Netherlands: third cross-sectional national study. Epidemiol Infect. 2023;151:e136.  https://doi.org/10.1017/S095026882300122X  PMID: 37503608 
  21. Qin X, Zhang S, Liu H, Cheng G, Liu Y, Hu M, et al. Seroepidemiology of TORCH Infections among 1.7 million women of childbearing age in rural China: a population-based cross-sectional study. Am J Trop Med Hyg. 2021;105(5):1202-9.  https://doi.org/10.4269/ajtmh.20-0137  PMID: 34544045 
  22. Robinson E, de Valk H, Villena I, Le Strat Y, Tourdjman M. National perinatal survey demonstrates a decreasing seroprevalence of Toxoplasma gondii infection among pregnant women in France, 1995 to 2016: impact for screening policy. Euro Surveill. 2021;26(5):1900710.  https://doi.org/10.2807/1560-7917.ES.2021.26.5.1900710  PMID: 33541484 
  23. Gras L, Gilbert RE, Wallon M, Peyron F, Cortina-Borja M. Duration of the IgM response in women acquiring Toxoplasma gondii during pregnancy: implications for clinical practice and cross-sectional incidence studies. Epidemiol Infect. 2004;132(3):541-8.  https://doi.org/10.1017/S0950268803001948  PMID: 15188723 
  24. Gomes Ferrari Strang AG, Ferrar RG, Falavigna-Guilherme AL. Gestational toxoplasmosis treatment changes the child’s prognosis: A cohort study in southern Brazil. PLoS Negl Trop Dis. 2023;17(9):e0011544.  https://doi.org/10.1371/journal.pntd.0011544  PMID: 37773943 
  25. Sawers L, Wallon M, Mandelbrot L, Villena I, Stillwaggon E, Kieffer F. Prevention of congenital toxoplasmosis in France using prenatal screening: A decision-analytic economic model. PLoS One. 2022;17(11):e0273781.  https://doi.org/10.1371/journal.pone.0273781  PMID: 36331943 
  26. De Paschale M, Manco MT, Paganini A, Agrappi C, Mirri P, Cucchi G, et al. Rubella antibody screening during pregnancy in an urban area of Northern Italy. Infect Dis Rep. 2012;4(1):e17.  https://doi.org/10.4081/idr.2012.e17  PMID: 24470924 
  27. Marchi S, Viviani S, Montomoli E, Trombetta CM. Elimination of congenital rubella: a seroprevalence study of pregnant women and women of childbearing age in Italy. Hum Vaccin Immunother. 2020;16(4):895-8.  https://doi.org/10.1080/21645515.2019.1688041  PMID: 31674859 
  28. European Centre for Disease Prevention and Control (ECDC). Measles and Rubella monthly report. Stockholm: ECDC; 28 Nov 2025. Available from: https://measles-rubella-monthly.ecdc.europa.eu
  29. Gallone MS, Gallone MF, Larocca AMV, Germinario C, Tafuri S. Lack of immunity against rubella among Italian young adults. BMC Infect Dis. 2017;17(1):199.  https://doi.org/10.1186/s12879-017-2724-y  PMID: 28270106 
  30. de Vries JJ, van Zwet EW, Dekker FW, Kroes AC, Verkerk PH, Vossen AC. The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population-based prediction model. Rev Med Virol. 2013;23(4):241-9.  https://doi.org/10.1002/rmv.1744  PMID: 23559569 
  31. Revello MG, Tibaldi C, Masuelli G, Frisina V, Sacchi A, Furione M, et al. Prevention of primary cytomegalovirus infection in pregnancy. EBioMedicine. 2015;2(9):1205-10.  https://doi.org/10.1016/j.ebiom.2015.08.003  PMID: 26501119 
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