Routine antenatal toxoplasmosis screening, is it necessary?

Toxoplasmosis is an intracellular parasite and one of the most common congenital infections. Currently, there is no clear consensus on routine screening for toxoplasma infection during pregnancy. This study aimed to discuss the results of antenatal toxoplasma screening in a tertiary center.

A retrospective study including the data of the antenatal toxoplasmosis screening test results over four years. Toxoplasma immunoglobulin M (IgM), toxoplasma immunoglobulin G (IgG), anti-IgG avidity test results, amniocentesis, and toxoplasma polymerase chain reaction (PCR) were obtained from the hospital records. Patients with missing toxoplasma IgM, IgG, anti-IgG avidity, test results were excluded from the study. In addition, the fetal outcomes and follow-up information for the newborns of pregnant women who gave birth in our hospital were recorded.

During the study period, a total of 49,292 toxoplasma IgM tests were examined. Fifty pregnant women whose toxoplasma IgM was positive with a low-anti-toxoplasma IgG avidity index were enrolled in the study group. Forty percent of the pregnant women are expected to have amniocentesis. There was only one termination of pregnancy with specific ultrasonographic findings. Toxoplasma PCR was found to be negative in the other pregnant women. Of the pregnant women who were followed up, 23 gave birth in our hospital and the Sabin Feldman test was positive in 65.2 percent (15/23) of the newborns.

Antenatal toxoplasmosis screening should be preserved for pregnant women with fetal ultrasonographic findings which may be related to toxoplasmosis. Further studies are needed.