Seroprevalence of Toxoplasma gondii, rubella virus, and cytomegalovirus among pregnant women with previous pregnancy loss

Abstract

Background. Infectious agents, especially TORCH infections, may contribute to unfavorable pregnancy outcomes, including pregnancy loss, a complex reproductive health issue. There is currently limited information available on the seroprevalence of these infections among pregnant women in southern Iraq. Objective. To determine the seroprevalence of Toxoplasma gondii, rubella virus, and cytomegalovirus (CMV) among pregnant women in Basrah, Iraq, who had experienced a previous miscarriage, and to assess their correlations with clinical factors. Methods. Between October 2024 and October 2025, 156 pregnant women with a history of spontaneous miscarriage and 100 pregnant women without such a history participated in a cross-sectional analytical study. The enzyme-linked fluorescent assay (ELFA) on the VIDAS automated platform was used for serological testing for IgG and IgM antibodies against T. gondii, rubella virus, and CMV (bioMérieux, France). The chi-square test, Fisher’s exact test, Spearman correlation, and Cramér’s V statistics were used to assess associations. Results. Among women who had previously experienced pregnancy loss, IgG seropositivity for T. gondii, rubella, and CMV was 79.5%, 84.6%, and 74.4%, respectively. No T. gondii IgM positivity was detected; 5.1% of women had CMV IgM positivity, and 1.3% had rubella IgM positivity. Moderate positive correlations were observed between age and IgG seropositivity for CMV (ρ = 0.38, p = 0.003) and T. gondii (ρ = 0.42, p = 0.001). Conclusion. In Basrah, pregnant women who had previously experienced pregnancy loss had high IgG seroprevalence rates for T. gondii, rubella, and CMV. Further prospective studies using confirmatory diagnostic techniques are needed in light of the observed association between CMV IgM seropositivity and previous pregnancy loss.