Screening for Toxoplasma gondii antibodies in 2, 513 consecutive parturient women and evaluation of newborn infants at risk for congenital toxoplasmosis

Lago, Eleonor Gastal; Carvalho, Rui Lara de; Jungblut, Rosana; Silva, Vanessa Beatriz da; Fiori, Renato Machado

Aims:

To determine the prevalence of seropositivity for toxoplasmosis in pregnant women, to assess the outcome and the prevalence of congenital toxoplasmosis, and to evaluate the usefulness of routine screening for Toxoplasma gondii antibodies in parturient women.

Methods:

Prospective cross-sectional study of consecutive mothers and their liveborn infants within the first 12 months of the implementation in a maternity ward of a routine consisting in screening for toxoplasmosis at delivery.

Results:

Serologic status for toxoplasmosis were assessed in 2,477 (98.5%) of 2,513 mothers of liveborn infants throughout the study period. Of the 2,477 mothers, 810 (32.7%; 95%CI 30.9-34.6%) were susceptible and 1,667 (67.3%; 95%CI 65.4-69.1%) were immune. Three newborn infants with congenital toxoplasmosis were identified because of the maternal serum tests at delivery, and all of them had The prevalence of congenital toxoplasmosis was 12/10,000 (CI 95%: 6/10,000-21/10,000).

Conclusions:

Maternal serologic screening at delivery was useful for the early detection of cases of congenital toxoplasmosis that would have otherwise gone undetected in the neonatal period, and allowed for earlier treatment of newborns with retinochoroiditis. The high prevalence of Toxoplasma gondii antibodies in pregnant women and of congenital toxoplasmosis justify a prenatal screening program in this population.The prevalence of congenital toxoplasmosis was 12/10,000 (CI 95%: 6/10,000-21/10,000).

Conclusions:

Maternal serologic screening at delivery was useful for the early detection of cases of congenital toxoplasmosis that would have otherwise gone undetected in the neonatal period, and allowed for earlier treatment of newborns with retinochoroiditis. The high prevalence of Toxoplasma gondii antibodies in pregnant women and of congenital toxoplasmosis justify a prenatal screening program in this population.

Objetivos:

Avaliar a prevalência de soropositividade para toxoplasmose em gestantes, investigar os desfechos clínicos e a prevalência da toxoplasmose congênita e verificar a utilidade da triagem de rotina para Toxoplasma gondii em parturientes.

Métodos:

Estudo prospectivo incluindo todas as mães e seus respectivos recém-nascidos vivos, durante os 12 primeiros meses de implantação, em uma maternidade, de uma rotina de triagem para toxoplasmose em parturientes.

Resultados:

Foi avaliado o estado imunológico para toxoplasmose em 2.477 (98,5%) entre as 2.513 mães de recém-nascidos vivos durante o período do estudo. Destas, 810 (32,7%; IC 95% 30,9-34,6%) eram suscetíveis e 1.667 (67.3%; IC 95% 65,4-69,1%) eram imunes. Foram diagnosticados três casos de toxoplasmose congênita apenas pela sorologia materna na hora do parto, sendo que os três pacientes apresentavam lesões ativas de retinocoroidite toxoplásmica A prevalência de toxoplasmose congênita foi de 12/10.000 (IC 95%: 6/10.000-21/10.000).

Conclusões:

A sorologia materna no momento do parto foi útil na identificação precoce de casos de toxoplasmose congênita que teriam passado despercebidos no período neonatal, permitindo o tratamento precoce de bebês com retinocoroidite. Nesta população, a elevada prevalência encontrada, tanto de anticorpos anti-Toxoplasma gondii nas gestantes, quanto de toxoplasmose congênita, justificam um programa de triagem pré-natal.