title: Diagnosis of congenital toxoplasmosis in the neonatal period: A multicenter evaluation.
abstract: OBJECTIVE
  To evaluate different laboratory tests used to diagnose congenital toxoplasmosis in the neonatal period.
  
  
  METHODS
  A retrospective multicenter study of 294 pregnant women who experienced seroconversion for Toxoplasma gondii and subsequently delivered live-born infants. Fetal infection was assessed via specific IgM and IgA antibodies (cord and neonatal blood) and detection of T gondii in placenta and cord blood by mouse inoculation.
  
  
  RESULTS
  Ninety-three (32%) of the 294 infants were congenitally infected. The sensitivity of IgA in cord blood and in neonatal blood was 64% and 66%; the sensitivity of IgM was 41% and 42%, respectively. Mouse inoculation of the placenta and cord blood had sensitivities of 45% and 16%. Positive results of the serologic tests in congenitally infected children correlated significantly with the gestational age at the time of maternal infection but was not significantly influenced by the administration of specific antiparasitic treatment during pregnancy.
  
  
  CONCLUSIONS
  Specific T gondii IgA antibody is a more sensitive test than IgM for detecting congenital toxoplasmosis in the neonatal period. The overall specificity is better for serologic tests performed on neonatal blood than for those on cord blood. Neonatal screening with IgM or IgA antibodies will not detect the majority of children with congenital toxoplasmosis when the maternal infection occurred before the 20th week of pregnancy.
authors.affiliation: Departments of Microbiology and Obstetrics, Academisch Ziekenhuis, Free University of Brussels, Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Naessens
authors.forename: P A
authors.initials: PA
authors.lastname: Jenum
authors.forename: A
authors.initials: A
authors.lastname: Pollak
authors.forename: A
authors.initials: A
authors.lastname: Decoster
authors.forename: M
authors.initials: M
authors.lastname: Lappalainen
authors.forename: I
authors.initials: I
authors.lastname: Villena
authors.forename: M
authors.initials: M
authors.lastname: Lebech
authors.forename: B
authors.initials: B
authors.lastname: Stray-Pedersen
authors.forename: M
authors.initials: M
authors.lastname: Hayde
authors.forename: J M
authors.initials: JM
authors.lastname: Pinon
authors.forename: E
authors.initials: E
authors.lastname: Petersen
authors.forename: W
authors.initials: W
authors.lastname: Foulon
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D002955:Leucovorin / Q000627:therapeutic use; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015572:Spiramycin / Q000627:therapeutic use; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D015572:Spiramycin; D002955:Leucovorin