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Congenital toxoplasmosis and prenatal care state programs
BACKGROUND: Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918215/ https://www.ncbi.nlm.nih.gov/pubmed/24438336 http://dx.doi.org/10.1186/1471-2334-14-33 |
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author | Avelino, Mariza M Amaral, Waldemar N Rodrigues, Isolina MX Rassi, Alan R Gomes, Maria BF Costa, Tatiane L Castro, Ana M |
author_facet | Avelino, Mariza M Amaral, Waldemar N Rodrigues, Isolina MX Rassi, Alan R Gomes, Maria BF Costa, Tatiane L Castro, Ana M |
author_sort | Avelino, Mariza M |
collection | PubMed |
description | BACKGROUND: Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. METHODS: We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. RESULTS: A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. CONCLUSION: Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the environment. |
format | Online Article Text |
id | pubmed-3918215 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39182152014-02-09 Congenital toxoplasmosis and prenatal care state programs Avelino, Mariza M Amaral, Waldemar N Rodrigues, Isolina MX Rassi, Alan R Gomes, Maria BF Costa, Tatiane L Castro, Ana M BMC Infect Dis Research Article BACKGROUND: Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. METHODS: We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. RESULTS: A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. CONCLUSION: Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the environment. BioMed Central 2014-01-18 /pmc/articles/PMC3918215/ /pubmed/24438336 http://dx.doi.org/10.1186/1471-2334-14-33 Text en Copyright © 2014 Avelino et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Avelino, Mariza M Amaral, Waldemar N Rodrigues, Isolina MX Rassi, Alan R Gomes, Maria BF Costa, Tatiane L Castro, Ana M Congenital toxoplasmosis and prenatal care state programs |
title | Congenital toxoplasmosis and prenatal care state programs |
title_full | Congenital toxoplasmosis and prenatal care state programs |
title_fullStr | Congenital toxoplasmosis and prenatal care state programs |
title_full_unstemmed | Congenital toxoplasmosis and prenatal care state programs |
title_short | Congenital toxoplasmosis and prenatal care state programs |
title_sort | congenital toxoplasmosis and prenatal care state programs |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918215/ https://www.ncbi.nlm.nih.gov/pubmed/24438336 http://dx.doi.org/10.1186/1471-2334-14-33 |
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