Study On Influencing Factors And Adverse Pregnancy Outcome Of TORCH Infection In Second Pregnancies

China is a big country with a large population.Since the implementation of the family planning policy,it has contributed to controlling the excessive population growth in our country and alleviating the pressure on population and environment resources.However,with the further development of the social economy,China is faced with problems such as reduced fertility of the population,pension crisis,aging,accelerated shortage of young and old labor,and real estate bubbles[1].In response to growing social pressures,the government introduced a "separate two-child" and a"comprehensive two-child" policy in 2014.As a fertility province in the country,more and more parents choose to have a second child[2].Because the maternal age of the second child is generally high,the physical quality is generally lower than that of a pregnant woman,and the consciousness of preparing pregnant also declines.Therefore,the birth and birth of the second child becomes an important issue.The TORCH test during pregnancy is one of the important contents of prenatal and postnatal education.It was first proposed by Nahmias et al.[3]in 1971.TORCH refers to the English name abbreviations of four pathogenic microorganisms,namely Toxopasma and Rubella virus R(Rubella,cytomegalovirus C(Cytomegalo),herpes simplex virus type 1/2 H(Herpes),O refers to others[4-5].This group of microbial infections can cause maternal and child infections.It has been reported that the proportion of fetal and neonatal malformations caused by TORCH infection in live births is about 2%.Domestic research shows that the infection rate varies greatly,and the TORCH infection rate varies among different pregnant women[6].As early as the 1970s,developed countries such as Europe and the United States listed TORCH testing as a screening program during pregnancy.According to statistics,about 600,000 babies are born every year in China,and TORCH infection is one of the important causes of birth defects.With the progress of social development,people pay more and more attention to TORCH screening.In the 2011 Chinese Medical Association Obstetrics and Gynecology Observatory's Obstetrics Group:"Pre-pregnancy and Pregnancy Health Care Guidelines" first edition listed TORCH screening as the first three months of pregnancy as the first-line reference item to reduce the risk of birth defects and achieve eugenics.At present,TORCH studies at home and abroad are mostly positive rates of TORCH test during pregnancy and its adverse pregnancy outcomes.There is no explicit study on the reproductive and first-born childbearing virus infection and its effects.China's second-child policy has been implemented since 2016.At present,there are few reports on the second-child status in China.Therefore,it is necessary to carry out research on the difference between the positive rate of TORCH test and the adverse pregnancy outcome in the first and second-trimester pregnancy.Clinical guidance there are women of childbearing age who have the intention of giving birth to two children.In this study,TORCH infection was screened for the second-born mothers of Qilu Hospital of Shandong University in 2016 to analyze the risk of TORCH infection in the second child,which can provide clinical evidence for the development of the second child.Objective:In this study,we examined the results of the second-pregnant women's TORCH test and the collection of basic information on the outcomes of pregnancy in the Qilu Hospital of Shandong University in 2016.We analyzed the risk of TORCH infection in the second-born,the influencing factors,and the impact of TORCH infection on the pregnancy outcome.The clinical basis is provided for the health care of women of childbearing age after opening a second child and the prenatal and postnatal care for the second child.Method:1.Study time,place and research object:Study time:January 1,2016-January 1,2018 Research Location:Shandong University Qilu Hospital Subject:The age of 19-49 years old came to the hospital to test pregnant women.2.Prospective cohort studyThe pregnancy outcomes of the study subjects were followed up.The follow-up outcomes were pregnancy outcomes(abortion,stillbirth,normal delivery,etc.)of the tested pregnant women.The follow-up period was from January 1,2016 to January 1,2018.3.Specimen collectionThe pregnant women to be tested were fasted for 12 hours,and 3 ml of venous blood was collected on an empty stomach in the early morning,placed in a non-anticoagulated test tube,and the serum was separated for TORCH detection.4.TORCH detectionThe indirect chemiluminescent immunoassay was used to detect herpes simplex virus type I,rubella virus,cytomegalovirus,and Toxoplasma gondii IgQ and thecapture antibody chemiluminescent immunoassay was used to determine the IgM antibodies of these pathogens.All test kits were purchased from Soling Medical Equipment(Shanghai)Co.,Ltd.The experimental operation was performed according to the kit instructions.The experimental results were read and recorded by the Soling automated chemiluminescent immunoassay system.5.Data collection,processing and analysisAccess to medical records to collect and record the basic information of first-and second-born pregnant women who tested positive for TORCH infection,including age,education level,history of abnormal pregnancy,urban-rural distribution,and monthly income.The pregnancy outcomes of these pregnant women were followed up from January 1,2016 to January 1,2018.Pregnancy outcomes(abortion,stillbirth,normal delivery,etc.)of first and second-born pregnant women during the follow-up period were used as research subjects,and then statistical analysis was performed using Excel2010 and spss24.0.Firstly,univariate analysis was performed on the relevant influencing factors of TORCH infection.Logistic regression was then used for further multivariate analysis.TORCH infections and pregnancy outcomes were statistically analyzed.Result:1.TORCH infection rate analysis of first and second childA total of 1849 subjects were enrolled in this study,A total of 125 people were infected with TORCH,and the infection rate was 6.76%.The first-child infection rate was 6.32%;the second-infection rate was 7.01%.The chi-square test results showed that the difference between the first and second child TORCH infection rates was not statistically significant(X2=0.33,P>0.05),and the infection rate between the first child and the second child was not considered to be different.2.Analysis of the status of TORCH infection in pregnant women with second childAmong the 1184 cases of second-pregnant women,83 cases of TORCH infection were detected,and the infection rate was 7.018%.Among them,9 cases(10.84%)had rubella virus infection,13 cases(15.67%)of Toxoplasma infection,and 16 cases(19.28%)of giant cell infection.Of the 45 patients(54.22%)infected with herpes simplex virus(1/2),herpes simplex virus(type 1/2)was the most common type of infection.3.Univariate analysis resultsThe univariate analysis of the influencing factors of TORCH infection in 1184 pregnant women with second child showed that there were statistically significant differences between education level,history of abnormal pregnancy,urban-rural distribution,and income levels(?2,35.59,123.95,respectively).7.13,16.6(P<0.05).No statistical difference was found in the TORCH infection rate between pregnant women under the age of 35 and pregnant women over the age of 35.4.Logistics multi-factor analysis resultsUrban-rural distribution and abnormal pregnancy history were risk factors for TORCH infection in pregnant women(Wald)(2,9.21,6.95,and 19.86,respectively,P<0.05).Education level and income level were protective factors(Wald ?2 were 33.19 and 7.56,respectively,P<0.05)..Conclusion:The level of education,distribution in urban and rural areas,and income levels were related to second child TORCH infection.Hospitals and disease control and other related departments can determine the living conditions in rural areas with poor living conditions and low level of education based on the analysis of the risk factors of TORCH infection in this study.The second generation of pregnant women with low awareness of protection is a high-risk group for TORCH infection,and focuses on the women of child-bearing age at this high-risk group are required to provide publicity and education on TORCH infection prevention during pregnancy and pregnancy,and to strengthen the personal hygiene and protection of pregnant women during pregnancy.The hospital should also do a good job in pre-pregnancy screening of pregnant women with TORCH infection and serological TORCH of pregnant women.Screening for early detection of TORCH infections and timely control measures to increase the quality of the population and promote health for all.