ArticlesMother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling
Section snippets
Inroduction
Toxoplasma gondii infection acquired during pregnancy can cross the placenta and cause congenital toxoplasmosis.1 Prenatal serological screening to detect maternal infection is used in many European countries,2 although the benefits and costs have not been adequately assessed.3 After detection of maternal infection, patients are faced with decisions about invasive investigations for fetal diagnosis and drug regimens with potential adverse side-effects, and the possibility of a therapeutic
Patients
We collected data on women referred to the laboratory between August, 1987, and October, 1995, during which time standard protocols were used. The analysis is limited to women in whom infection occuring during pregnancy was confirmed. In an attempt to eliminate major sources of bias we excluded women if there was any doubt that the referral had been prompted by suspicion of infection in the fetus or infant (eg, positive amniocentesis or clinical symptoms); excluded women if specific IgG
Results
The analysis is based on 603 confirmed maternal infections. Three women gave birth to twins, all born with concordant infection status. Data are reported on the first-born twin only. No woman was known to be HIV infected or to have any other disorder that might compromise her immune response. Clinical symptoms associated with maternal infection were reported by only 36 (5%) women. The mean age at referral was 24 years (range 16–44).
Antiparasitic treatment was prescribed for 564 women (at least
Discussion
Our study provides important information about the risks of congenital toxoplasmosis and the clinical sequelae for infants of women who seroconvert during pregnancy. Further studies are needed to quantify the risks to the fetus in women who are found to be IgM seropositive at the first test in pregnancy, although these will be substantially smaller. Previous estimates were based mainly on referrals for prenatal diagnosis of infection, which do not cover late maternal infections since
References (26)
- et al.
What is known about the prevention of congenital toxoplasmosis?
Lancet
(1990) - et al.
Termination of pregnancy for maternal toxoplasmosis
Lancet
(1994) - et al.
Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment
J Peds
(1989) - et al.
Toxoplasmosis
- et al.
Die Pravention der kongenitalen toxoplasmose in Europa
Schweiz Med Wochenschr
(1995) Congenital toxoplasmosis
BMJ
(1992)- et al.
Toxoplasmose congenitale. Etude prospective d l'issue de la grosesse chez 542 femmes atteintes de toxoplasmose acquise en cours de gestation
Ann Pediatr
(1984) - et al.
Fetal diagnosis of toxoplasmosis in 190 women infected during pregnancy
Prenat Diagn
(1994) - et al.
Prenatal diagnosis of congenital toxoplasmosis with a polymerase chain reaction test on amniotic fluid
N Engl J Med
(1994) Screening programme for congenital toxoplasmosis in France
Scand J Infect Dis Suppl
(1992)
Congenital toxoplasmosis: mother-to-child transmission of prepregnancy infection
Presse Med
An improved assay for the detection of toxoplasma gondii antibodies in human serum by flow cytometry
Cytometry
Etude d'une série homogène de 210 cas de toxoplasmose congénitale chez des nourrisons agés 0 à 1 mois dépistés de façon prospective
Semin Hôp Paris
Cited by (532)
Identification and validation of reference genes of circulating microRNAs for use as control in gestational toxoplasmosis
2023, Molecular and Biochemical ParasitologyPast and present seroprevalence and disease burden estimates of Toxoplasma gondii infections in Germany: An appreciation of the role of serodiagnostics
2023, International Journal of Medical MicrobiologyHost-pathogen interactions mediated by extracellular vesicles in Toxoplasma gondii infection during pregnancy
2023, Journal of Reproductive Immunology