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Toxoplasmosis: maternal and pediatric findings in 23,000 pregnancies
J L Sever1, J H Ellenberg, A C Ley
1National Institute of Neurological and Communicative Disorders and Stroke, Bethesda, Maryland 20892.
Insights
Maternal toxoplasmosis antibodies in pregnant women are linked to increased risks of deafness, microcephaly, and low IQ in children. High antibody titers indicate a significant risk for adverse congenital outcomes.
Area of Science:
- Medical research
- Infectious disease epidemiology
- Maternal and child health
Background:
- Toxoplasmosis, an infection caused by *Toxoplasma gondii*, can be transmitted from mother to child during pregnancy.
- Congenital toxoplasmosis can lead to severe neurological and developmental problems in infants.
- Understanding the impact of maternal antibody titers is crucial for risk assessment and intervention.
Purpose of the Study:
- To analyze the association between maternal toxoplasmosis antibody titers and clinical/laboratory findings in children up to age 7.
- To identify high-risk maternal serological profiles for congenital toxoplasmosis.
- To quantify the risks of specific developmental outcomes in children exposed to maternal toxoplasmosis.
Main Methods:
- Analysis of antibody titers to toxoplasmosis in 22,845 pregnant women from the Collaborative Perinatal Project.
- Correlation of maternal antibody levels with child outcomes through 7 years of age, considering over 900 observations per mother-child pair.
- Identification of a high-risk maternal group based on specific antibody levels (IHA, IgM IFA, IgM ELISA) and seroconversions.
Main Results:
- High maternal antibody titers (256-512) predicted a doubling in deafness frequency, a 60% increase in microcephaly, and a 30% increase in low IQ (<70) in children.
- A serologically defined high-risk group showed increased IgM levels and seroconversions.
- In the high-risk group (15 pregnancies), two children had congenital toxoplasmosis, and three were stillborn.
Conclusions:
- Maternal toxoplasmosis infection, indicated by specific antibody titers, significantly increases the risk of adverse neurological and developmental outcomes in children.
- Early identification of high-risk pregnancies through serological markers is essential for managing congenital toxoplasmosis.
- Further research is warranted to explore preventative strategies and long-term developmental impacts.
Abstract:
An analysis of the antibody titers to toxoplasmosis for 22,845 pregnant women in the Collaborative Perinatal Project was conducted in relation to clinical and laboratory findings in the mothers and children through 7 years of age. More than 900 observations were considered for each mother and child. The major findings were in the children and included a predicted doubling in the frequency of deafness among children born to women with antibody to toxoplasmosis, a predicted 60% increase in microcephaly, and a 30% increase in low IQ (less than 70) in association with the presence of high maternal antibody titer (256 to 512) to toxoplasma. A serologically defined high-risk group of mothers was identified on the basis of high indirect hemagglutination antibody levels or seroconversions and increased IgM toxoplasma antibody levels (indirect fluorescent antibody greater than or equal to 32, enzyme-linked immunosorbent assay greater than or equal to 0.7). Of the 15 pregnancies in this group, two children had congenital toxoplasmosis and three were stillborn.