Follow-up of infants with congenital toxoplasmosis detected by polymerase chain reaction analysis of amniotic fluid.
This study was conducted to assess the validity of performing the polymerase chain reaction (PCR) on amniotic fluid for detecting fetal Toxoplasma infection. The primary endpoint was the outcome of the infant at 1 year of age. A prospective, consecutive study was performed in 49 infants born to mothers with primary Toxoplasma infection during pregnancy. PCR determinations of Toxoplasma gondii DNA in amniotic fluid were carried out as part of their prenatal management. Infants were examined at birth, and at 1, 3, 6, 9, and 12 months of age. Nine of 11 infants from pregnancies with positive PCR results proved to be infected based on follow-up serological investigations conducted during the first year of life. Two fetal deaths occurred. All 38 infants with negative PCR results remained uninfected at 1 year of age, irrespective of whether their mothers had received treatment with sulfadiazine/pyrimethamine or spiramycin alone. Psychomotor development was normal in all infants. This follow-up study confirms that PCR performed on amniotic fluid is a useful method for identification or exclusion of fetal Toxoplasma infection. Treatment of infected pregnant women and - in the event of a positive PCR result subsequent treatment of their infants is associated with a favorable outcome.
Department of Neonatology and Intensive Care, University Children's Hospital, Vienna, Austria.
R
R
Gratzl
M
M
Hayde
C
C
Kohlhauser
M
M
Hermon
G
G
Burda
W
W
Strobl
A
A
Pollak
D000328:Adult; D000653:Amniotic Fluid / Q000469:parasitology*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D016054:DNA, Protozoan / Q000032:analysis*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000188:drug therapy; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D015203:Reproducibility of Results; D015572:Spiramycin / Q000627:therapeutic use; D013411:Sulfadiazine / Q000627:therapeutic use; D014122:Toxoplasma / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000175:diagnosis* / Q000188:drug therapy; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis* / Q000469:parasitology
D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D013411:Sulfadiazine; D015572:Spiramycin; D011739:Pyrimethamine