Roma – Infections that are transmitted from mother to fetus during pregnancy pregnancy, childbirth or breastfeeding still represent an underestimated threat. Diseases such as toxoplasmosis, rubella, cytomegalovirus and syphilis can cause serious damage to the unborn child, such as deafness, developmental delays and blindness.
These are the so-called Torch or Torches, an acronym which stands for Toxoplasmosis, Infectious Diseases (syphilis, HIV, hepatitis B, chickenpox, parvovirus B19, etc.), Rubella, Cytomegalovirus (CMV), Herpes simplex virus (HSV), Enterovirus and other pathogens (e.g. Zika virus, group B streptococcus).
The increasing numbers and risks for newborns, according to experts, highlight the need to create a system and strengthen screening and prevention campaigns. For this reason, a national network is born, involving institutions, scientific societies, civil society and businesses, to "join forces and guarantee universal access to screening and preventive therapies".
The initiative was launched today in Rome during the conference entitled 'The complexity of maternal-fetal infections and the crucial role of diagnostics in the management of Torch infections', organized on the initiative of Senator Guido Quintino Liris, member of the Parliamentary Intergroup for the Prevention and Control of Infectious Diseases, with the support of the Association of Italian Clinical Microbiologists (Amcli), Cittadinanzattiva, Diasorin, Federchimica Assobiotec.
“In a National Health Service that can make use of technologies, personalized and predictive medicine and advanced research,” Liris underlined, “prevention and early diagnosis represent the keystone of sustainability, as they allow greater possibilities of recovery on the one hand and the stability of public finances on the other.
The prenatal setting is one of the most complex but also important elements of prevention: an intervention during pregnancy can make a difference in terms of quality of life, both for the woman and for the unborn child. health in one of the most exciting but also delicate phases of the life of a woman and her child. Furthermore, in a context in which births are increasingly fewer, it is essential to avoid interference”.
A Silent Emergency: The Case of Cytomegalovirus (CMV)
In Italy, however, approximately 13 primary Cytomegalovirus infections are observed each year in pregnant women. One newborn in 150 is born with this infection. Although only 10-15% show symptoms at birth, up to 1 in 4 may develop serious consequences in the first years of life, such as deafness or delays in neuropsychomotor development.
CMV is recognized as the most common virus to cause intrauterine infections and is responsible for approximately 10% of all cases of cerebral palsy and 8-21% of cases of sensorineural hearing loss at birth, a percentage that increases to 25% within the first four years of life. In general, 30-40% of pregnant women are susceptible to CMV and can acquire a primary infection during pregnancy which remains the main cause of transmission of the virus from mother to fetus.
Since December 2023, maternal serological screening for CMV during pregnancy is recommended by the Physiological Pregnancy Guidelines and in 2025 it will be included in the Essential Levels of Assistance (Lea). Antiviral therapy to prevent maternal-fetal transmission of the virus has already been free since 2020 thanks to Aifa; nevertheless, regional heterogeneity in neonatal screening remains.
“Cytomegalovirus is the main cause of congenital infection in high-income countries,” explained Professor Tiziana Lazzarotto, Professor of Microbiology and Clinical Microbiology at the Alma Mater Studiorum University of Bologna, Director of the UOC of Microbiology at the IRCCS AOU of Bologna, and Scientific Director of Amcli, during the conference. “Thanks to the new ISS Guidelines and their implementation in the Lea, we can now identify at-risk pregnant women early and intervene promptly with drugs that have no side effects for mother and child.
Monitoring the serological status from conception until mid-pregnancy is essential to protect the unborn child: the neurological risk is directly related to the time of infection, especially in the first trimester”.
Toxoplasmosis in pregnancy: still a high risk
Toxoplasmosis contracted during pregnancy as a primary infection, experts explained today in the Senate, can cause spontaneous abortion, hydrocephalus, brain lesions (particularly calcifications) and chorioretinitis, with permanent consequences.
The risks come from the consumption of raw or undercooked meat (30-63% of cases), sausages, contact with cat feces, which is the natural reservoir of Toxoplasma, contaminated soil or water. Screening is provided by the LEA at the first prenatal check and then every 4-6 weeks, if the result is negative.
“Since over 90% of future mothers with toxoplasmosis are asymptomatic, it is crucial to know their serological status from the beginning of the pregnancy - highlighted Professor Marcello Lanari, full professor of general and specialist Pediatrics at the Alma Mater Studiorum University of Bologna and director of the Pediatrics UOC at the Irccs Aou of Bologna - hand hygiene, correct diet and targeted drugs according to medical prescription in case of fetal infection are the weapons.
It is essential that women know their serological status for all TORCH infections, from the beginning of pregnancy or even better when planning it, in order to adopt hygiene-food measures and targeted therapies to protect the unborn child, considering the fact that the greatest risk of fetal involvement is in the first and second trimester, with a possible poor prognosis”.
Sero-prevalence data in 2025: the Amcli study is coming
A study conducted by Amcli, which is expected to be published in the next few months in the scientific journal 'Eurosurveillance', documents a presentation of the sero-prevalence (presence of antibodies in the blood) of CMV and Toxoplasma gondii, confirming trends already observed in other European countries. The following values emerge from the representative sample of Italian women of childbearing age: Toxoplasma gondii: 10%; Parvovirus B19: 64%; Treponema pallidum (syphilis): 1%; Rubella virus: 86%; Cytomegalovirus (CMV): 59%.
In foreign women of childbearing age in Italy, however: Toxoplasma gondii: 22%; Parvovirus B19: 57%; Treponema pallidum: 1%; Rubella virus: 86%; VMC: 93%. Thanks to mandatory pediatric vaccination and coverage above 95%, Italy was declared 'free' from endemic rubella circulation at the end of 2023. But "it remains crucial", according to experts, screening of foreign women coming from countries without vaccination recommendations, to "prevent imported cases". The greatest attention is therefore focused on Cytomegalovirus and Toxoplasmosis.
Article published on 12 June 2025 - 15:45
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