Serological Prevalence of IgM and IgG Antibodies Against TORCH Infection in Pregnant Women of Peshawar, Khyber Pakhtunkhwa

Abstract

Background: TORCH infections—Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), and herpes simplex virus (HSV)—are important causes of adverse pregnancy outcomes, including miscarriage, congenital anomalies, and neonatal morbidity. Because maternal infections are often asymptomatic, serological screening remains essential for identifying exposure and potential recent infection in pregnant women, particularly those with adverse obstetric history in resource-limited settings. Objective: To determine the seroprevalence of IgM and IgG antibodies against TORCH pathogens and evaluate age-related patterns and co-seropositivity among pregnant women attending antenatal care in Peshawar, Pakistan. Methods: A cross-sectional observational study was conducted among 384 pregnant women presenting with clinical suspicion of TORCH infection or bad obstetric history at the Obstetrics and Gynecology outpatient department of Lady Reading Hospital, Peshawar, between January and July 2018. Venous blood samples were collected and analyzed using enzyme-linked immunosorbent assay (ELISA) kits to detect pathogen-specific IgM and IgG antibodies against T. gondii, rubella virus, CMV, and HSV-2. Data were analyzed using SPSS version 20, and seroprevalence was calculated with age-stratified comparisons. Results: Overall seropositivity was highest for rubella virus (199/384; 51.8%), followed by HSV-2 (171/384; 44.5%), CMV (166/384; 43.2%), and T. gondii (113/384; 29.4%). IgG antibodies predominated for rubella (167 cases), CMV (145 cases), and HSV-2 (153 cases), indicating widespread prior exposure, whereas IgM positivity suggesting possible recent infection was most frequent for T. gondii (70 cases) and HSV-2 (64 cases). The highest proportion of seropositive cases occurred among women aged 22–26 years. Co-seropositivity between multiple TORCH pathogens, particularly CMV and rubella, was also observed. Conclusion: TORCH infections remain prevalent among high-risk pregnant women in Peshawar, with evidence of widespread past exposure and notable levels of possible recent infection for certain pathogens. These findings highlight the importance of targeted antenatal screening, preventive education, and further large-scale studies incorporating confirmatory diagnostics to better define the burden of congenital infections.