Assessment of Immunological Parameters among Women with Pregnancy Loss in Babylon City, Iraq: A Seroprevalence Study

Hussain Ali Rzoqy; Zahraa Qais Jasim; Ahmed Ali Khesbak; Nawras A. Esmaeel

doi:10.31632/ijalsr.2026.v09i03.014

Hussain Ali Rzoqy Al-Furat Al-Awsat Technical University / Karbala Technical Institute, Babylon-Najaf Street, Najaf, Najaf Governorate, 54003, Iraq https://orcid.org/0009-0002-9736-8938
Zahraa Qais Jasim Al-Furat Al-Awsat Technical University / Karbala Technical Institute, Babylon-Najaf Street, Najaf, Najaf Governorate, 54003, Iraq https://orcid.org/0009-0007-3033-1598
Ahmed Ali Khesbak Al-Furat Al-Awsat Technical University / Karbala Technical Institute, Babylon-Najaf Street, Najaf, Najaf Governorate, 54003, Iraq https://orcid.org/0009-0007-1953-4239
Nawras A. Esmaeel Al-Furat Al-Awsat Technical University / Karbala Technical Institute, Babylon-Najaf Street, Najaf, Najaf Governorate, 54003, Iraq https://orcid.org/0000-0002-5818-5525

DOI https://doi.org/10.31632/ijalsr.2026.v09i03.014

Abstract

Background: Pregnancy loss is attributed to several factors involved in human reproduction. Genetic and uterine abnormalities, endocrine and immunological dysfunctions, infectious agents, environmental pollutants, psychogenetic factors, and endometriosis are among the most significant causes of spontaneous abortion. Objectives: This study aimed to determine the potential role of anticardiolipin (ACL) and anti-phospholipid (APS) antibodies, alongside Toxoplasma gondii and Rubella virus infections, in the occurrence of pregnancy-related complications and recurrent miscarriages. Methods: A case-control study was conducted involving 300 participants aged 18-45 years in Babylon city from March 15 to May 25, 2023. The case group comprised 250 women with a history of one or more consecutive unexplained spontaneous abortions. The control group consisted of 50 healthy pregnant women with no history of miscarriage. Serum levels of ACL, APS, and antibodies (IgM and IgG) against T. gondii and Rubella virus were evaluated using the automated MiniVIDAS apparatus (Enzyme-Linked Fluorescent Assay - ELFA system) according to manufacturer protocols (bioMérieux, Marcy-l'Étoile, France; ref. 30400, 30410, 30420). Results: A highly significant association was observed between the gestational age (trimesters) and the seroprevalence of the studied etiological agents. The highest seropositivity rates for T. gondii IgM (81.6%), Rubella IgM (69.6%), ACL IgM (66.0%), and APS IgM (62.8%) were recorded among the cases. First-trimester miscarriages exhibited significantly higher seropositivity rates for all IgM markers compared to the second and third trimesters (P < 0.001). Notably, the control group showed 0% positivity for all IgM markers, highlighting a highly specific risk association (P < 0.001). Spearman's correlation analysis revealed strong negative correlations between IgM titers and gestational age: T. gondii (ρ = -0.72, P < 0.001), Rubella (ρ = -0.58, P < 0.01), ACL (ρ = -0.61, P < 0.01), and APS (ρ = -0.65, P < 0.001).Conclusion: This study demonstrates that acute infections and autoimmune markers are significantly associated with spontaneous abortion, particularly during the first trimester. The findings highlight the importance of early serological screening for TORCH infections and anti-phospholipid antibodies to improve maternal-fetal outcomes and reduce recurrent miscarriage rates in Iraq.

Keywords: Anticardiolipin, Anti-Phospholipids, Gestational Ag, Miscarriage, Pregnancy Loss, Seroprevalence, Rubella, Toxoplasma Gondii

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