TORCH-Related Maternal Infections in a Tertiary Referral Center: Diagnostic Pathways and Prenatal Management in the Context of Canadian and European Recommendations

Maternal TORCH-related infections remain a major cause of adverse pregnancy and neonatal outcomes despite advances in prenatal diagnosis and prevention. We conducted a retrospective observational study of 71 HIV-negative pregnant women referred to the Pediatric Infectious Diseases Unit of a tertiary referral center in Palermo, Italy, between June 2020 and December 2024 for suspected maternal TORCH infections. Demographic, microbiological, clinical, therapeutic, and neonatal data were retrospectively collected to characterize referral patterns, diagnostic pathways, treatment uptake, and pregnancy outcomes. Overall, 43 women (60.6%) had a confirmed maternal infection; cytomegalovirus (CMV) and Toxoplasma gondii accounted for most confirmed maternal infections. Maternal treatment was administered to 12/23 (52.2%) women with confirmed CMV infection and to all women with confirmed toxoplasmosis (17/17, 100%), corresponding to significantly greater treatment uptake for toxoplasmosis (p = 0.0008). Maternal demographic characteristics, obstetric history, treatment, and neonatal outcomes showed no significant association with trimester at referral. Three newborns were diagnosed with congenital CMV infection. Most referrals followed uncertain serological findings rather than clinically apparent maternal disease. These findings highlight the role of specialist assessment in clarifying maternal infection status, counseling patients, and informing pathogen-specific prenatal management; prospective multicenter studies are required to assess its effects on maternal and neonatal outcomes.