Investigation of the Incidence and Perinatal Outcomes of Acute Toxoplasma Infection in Pregnancy: Results from the Tertiary Center of the Eastern Black Sea Region – Pages 1-5

Omer Demir1 and Mirac Ozalp2

1Department of Gynecology and Obstetrics, Karadeniz Technical University School of Medicine, Trabzon, Turkey; 2Department of Perinatology, Karadeniz Technical University School of Medicine, Trabzon, Turkey

DOI: https://doi.org/10.31907/2309-4400.2020.08.01

Abstract: Objective: Toxoplasma gondii is a common protozoan that can infect humans in various ways. Parasitic infections, which usually affect humans in childhood and adolescence, can be transmitted from mother to fetus if it occurs for the first time during pregnancy and it may result in a congenital toxoplasma infection.The aim of the study is to determine the incidence of acute toxoplasma infection during pregnancy and to evaluate the perinatal outcomes.

Materials and Methods: The study has been designed as a retrospective analysis of the data of all pregnant women who had attended the pregnancy outpatient clinic of the Department of Obstetrics and Gynecology at Karadeniz Technical University between 2014 and 2018. Patients within the first trimester of their pregnancy with Toxoplasma IgM positivity (≥ 1 index, ELISA, Elecsys®) and IgG positivity (≥ 3 IU / ml, ELISA, Elecsys®), who had low IgG avidity (<70% (ELISA, Elecsys®) were considered as having acute toxoplasmosis. Detailed ultrasonographic examinations were performed between the 20th and 23rd gestational weeks and the mothers and babies were followed up for over the ensuing six months.

Results: The total number of patients for whom the results of toxoplasma Ig tests were ordered was 11,045 and, of these patients, 157 were found to be both Ig M and Ig G positive. 29 of these 157 patients was with low Ig G avidity. So the incidence of acute toxoplasmosis was 0.26% in this clinic. The mean age of the 29 patients with low Ig G avidity was 28.86 +/- 4.69. All 29 patients agreed to receive antibiotic prophylaxis with Spiramycin and, consequently, they received Spiramycin prophylaxis during pregnancy. Of the patients diagnosed with acute toxoplasmosis; Toxo Ig M mean value was 4.58 +/- 4.60; Toxo Ig G mean value was 332 +/- 265.42 and Toxo Ig G avidity wasfound to be 50.37 +/- 14.16%. No pathological features were found in the postnatal follow-up of 26 babies who were delivered at the clinic.

Conclusion: Toxoplasma screening should be performed routinely for fetal morbidity and mortality during the first trimester of pregnancy in high-risk areas. Pregnant women should be informed about pre-natal counseling programs and first trimester applications with educational materials containing messages about the prevention of infection.

Keywords: Toxoplasmosis, pregnancy.