http://informahealthcare.com/jmf ISSN: 1476-7058 (print), 1476-4954 (electronic) J Matern Fetal Neonatal Med, Early Online: 1–4 ! 2015 Informa UK Ltd. DOI: 10.3109/14767058.2014.996127 ORIGINAL ARTICLE Toxoplasmosis-associated abortion and stillbirth in Tehran, Iran Fatemeh Sadat Ghasemi 1 , Sima Rasti 1 , Ahmad Piroozmand 2 , Mojgan Bandehpour 3,4 , Bahram Kazemi 3,4 , Seyed Gholam Abbas Mousavi 5 , and Amir Abdoli 1,6 1 Department of Parasitology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran, 2 Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran, 3 Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 4 Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 5 Department of Statistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran, and 6 Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Abstract Objectives: This study was aimed to evaluate the role of toxoplasmosis in etiology of abortion and stillbirth based on molecular and serological techniques. Material and methods: A total of 110 pregnant women with abortion and stillbirth were enrolled as the case group, and 110 pregnant women with normal delivery were enrolled as the control group. Serological and molecular detections of Toxoplasma gondii were assessed by ELISA and PCR methods. Results: The seroprevalence of IgG was 25.5% in the case group (26.8% in abortion and 21.4% in stillbirth) and 26.4% in the control group. IgM seropositivity was detected in 2.7% of the case group (3.6% in abortion and 0% in stillbirth) and 0.9% of the control group (p ¼ 0.37). Toxoplasma gondii DNA was detected in 6.4% of the case group (7.3% in abortion and 3.6% in stillbirth) and 1.8% of the control group by PCR (p ¼ 0.17). The major risk factor of congenital toxoplasmosis was the history of eating undercooked meat (p ¼ 0.06). Conclusion: Results of this study revealed that the rate of PCR positive in women with abortion and stillbirth was 3.7 times higher than that in normal delivery, but the difference was not statistically significant. These findings suggest that toxoplasmosis can be involved in etiology of abortion and stillbirth. Keywords Abortion, Iran, Toxoplasma gondii, stillbirth History Received 24 August 2014 Accepted 4 December 2014 Published online 7 January 2015 Introduction Spontaneous abortion is one of the most distressing problems in pregnant women, particularly in those who have no successful pregnancy [1]. Abortion is defined as termination of pregnancy before the 20th week of gestation. Abortion has an approximate prevalence of 15% worldwide. Stillbirth is defined as delivery of a dead baby after 24 completed weeks of pregnancy [1]. Congenital infections, such as congenital toxoplasmosis, are the most important causes of abortion [2]. Toxoplasmosis is one of the most widespread infectious diseases that has infected approximately one-third of the world’s human population [3,4]. Although it is estimated that 25–30% of the world’s human population has been infected by Toxoplasma gondii, the most common form of infection is asymptomatic [4,5]. Transmission of T. gondii in human generally occurs through consuming water or food contami- nated by oocysts excreted through feces of cats or under- cooked meat containing tissue cysts [3]. Transplacental transmission of T. gondii predominantly occurs at the first pregnancy [6]. Frequency and severity of congenital infection are correlated with the gestational age. The highest rate of this infection occurs in the third trimester of pregnancy, but the severity of infection achieves its highest in the first and second trimesters that can cause abortion or stillbirth [3,6,7]. Infection in the third trimester is usually asymptomatic at birth but may develop clinical symptoms in later life (i.e. chorioretinitis, slower mental and neurological development) [3]. Moreover, recent investigations have revealed that latent toxoplasmosis during pregnancy has several neuropsychiatric manifestations on mothers and their offspring in later life (reviewed in [8,9]). The global incidence rate of congenital toxoplasmosis is 190 100 cases annually with an approximate incidence rate of 1.5 cases per 1000 live births [10]. In Iran, results of the recent studies revealed that the overall seroprevalence rates of toxoplasmosis are 39.3% (95% CI ¼ 33.0–45.7%) among general population [11], and 39.9% (95% CI: 26.1–53.7) among childbearing age women [12]. Moreover, serological tests are common diagnostic meth- ods for congenital toxoplasmosis. However, these techniques sometimes fail to detect specific anti-T. gondii antibodies Address for correspondence: Dr. Sima Rasti, Department of Parasitology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran. Tel: +98 361 5550021, 98 9132611568 (Mobile). Fax: +98 3615551112. E-mail: rasti_s@yahoo.com J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by 78.39.6.25 on 01/07/15 For personal use only.