Lack of awareness of risk factors for primary toxoplasmosis in pregnancy
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The overall seroprevalence of toxoplasma antibodies in women of childbearing age in Ireland is 25% . Hence, 75% of women remain susceptible to primary toxoplasma infection during pregnancy, which if transmitted to the foetus can cause ocular, neurological and other sequelae. Toxoplasma exposure during pregnancy can be avoided if there is an awareness of the potential sources of infection, mainly contaminated food, water, soil and cat faeces.
To determine risk factor exposure in a cohort of women with congenitally infected infants and to assess maternal risk awareness prior to diagnosis of infection.
Data, prospectively gathered during 2 years of pilot newborn screening for congenital toxoplasmosis in Ireland, was retrospectively analysed. Known risk factors for acquisition of infection were identified. Women were questioned regarding risk awareness and implementation of avoidance measures, if any, during pregnancy.
Fifteen congenitally infected infants were identified by newborn screening. Seventy-three percent of their mothers (11/15) reported lack of knowledge concerning risk factors for toxoplasma infection or its potential threat to the foetus. Ingestion of raw or undercooked meat during pregnancy was the predominant source of toxoplasma cyst exposure identified. Contact with cats was reported in just one case.
Most women were uneducated about the risks posed by Toxoplasma gondii exposure during pregnancy. There is a clear need for better educational programmes regarding primary prevention of congenital toxoplasmosis if neonatal infection is to be avoided.
KeywordsToxoplasmosis Pregnancy Congenital toxoplasmosis Risk factors
The authors wish to thank Dr. E. Guy and the staff at The Toxoplasma Reference Laboratory, Singleton Hospital, Swansea, UK for conducting confirmatory serology and facilitating results. We also thank newborn screening liaison midwives nationwide, staff at The National Newborn Screening Laboratory and The National Virus Reference Laboratory Dublin, the infectious diseases team at Our Lady’s Children’s Hospital Dublin, Microbiology service teams for providing stored maternal serology, and Paediatric service teams nationwide for facilitating infant evaluation. We acknowledge the women who consented to participate in this study. The National Pilot Newborn Screening Programme for Congenital Toxoplasmosis was funded by the Department of Health and Children.
Conflict of interest
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