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Prenatal screening for toxoplasmosis

T J Bader1, G A Macones, D A Asch

  • 1Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, USA. tbader@obgyn.upenn.edu

Obstetrics and Gynecology
|September 1, 1997
PubMed
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Universal screening for toxoplasmosis in pregnant women is not recommended. While it reduces congenital toxoplasmosis cases, the clinical costs, including pregnancy losses, outweigh the benefits.

Area of Science:

  • Medical screening
  • Maternal-fetal medicine
  • Infectious disease epidemiology

Background:

  • Congenital toxoplasmosis poses risks to newborns.
  • Current screening practices are targeted, not universal.
  • Management options include antiparasitic treatment or termination.

Purpose of the Study:

  • To evaluate the effectiveness and risks of universal maternal screening for toxoplasmosis.
  • To compare universal screening with no testing and targeted screening strategies.

Main Methods:

  • Decision analysis modeling was used.
  • Three screening strategies were compared: none, targeted, and universal.
  • Two management options were analyzed: treatment and termination.

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Main Results:

  • Universal screening reduced congenital toxoplasmosis cases.
  • However, universal screening led to increased pregnancy losses compared to no testing.
  • 18.5 additional losses per toxoplasmosis case avoided with medical treatment.
  • 12.1 additional losses per case avoided with pregnancy termination.

Conclusions:

  • Maternal screening for toxoplasmosis reduces disease incidence but incurs significant clinical costs.
  • The rarity of toxoplasmosis, diagnostic limitations, and risks of amniocentesis limit screening effectiveness.
  • Universal maternal screening for congenital toxoplasmosis is not advised.