An investigation into the incidence of toxoplasmosis in pregnancy in New Zealand.
OBJECTIVE
To estimate the incidence of toxoplasmosis in pregnancy in New Zealand and consider whether there is a case for screening women in pregnancy.


METHODS
The risk of maternal and fetal infection with toxoplasmosis was derived by first determining the rate of maternal seroconversion based on seroprevalence studies. The age-specific number of seroconversions in pregnancy was then estimated from the birth rate. Using reported fetal infection rates after primary maternal infection, the expected number of congenitally infected infants in one year was estimated. These incidences were compared with the number of recognised cases of toxoplasmosis infection in pregnancy and the actual number of positive IgM results at the Wellington Hospital laboratory. Using national births data, this incidence was extrapolated to estimate the number of expected cases in New Zealand.


RESULTS
The annual seroconversion rate was 0.62% (95% confidence interval 0.39-0.86). On this basis, 164 primary maternal infections are expected annually with 66 fetuses being infected. Ten patients tested positive for IgM in Wellington, which averaged only one case per year being identified over the time examined in this study.


CONCLUSIONS
Very few of the expected cases in pregnancy are diagnosed. Reporting rates were low when toxoplasmosis was a notifiable disease. Other means of improving detection, reporting and the avoidance of infection are discussed. More information is required before screening can be recommended in New Zealand.
Moor
C
C
Department of Obstetrics and Gynaecology, Wellington School of Medicine, University of Otago.
Stone
P
P
Purdie
G
G
Weinstein
P
P
D000293:Adolescent; D000328:Adult; D002648:Child; D018563:Disease Notification / Q000706:statistics & numerical data; D005260:Female; D006285:Health Planning; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D016036:Seroepidemiologic Studies; D014123:Toxoplasmosis / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control