Ecological comparison of the risks of mother-to-child transmission and clinical manifestations of congenital toxoplasmosis according to prenatal treatment protocol.
We compared the relative risks of mother-to-child transmission of Toxoplasma gondii and clinical manifestations due to congenital toxoplasmosis associated with intensive prenatal treatment in Lyon and Austria, short term treatment in 51% of Dutch women, and no treatment in Danish women. For each cohort, relative risks were standardized for gestation at seroconversion. In total, 856 mother-child pairs were studied: 549 in Lyon, 133 in Austria, 123 in Denmark and 51 in The Netherlands. The relative risk for mother-to-child transmission compared to Lyon was 1.24 (95% CI: 0.88, 1.59) in Austria; 0.59 (0.41, 0.81) in Denmark; and 0.65 (0.37, 1.01) in The Netherlands. Relative risks for clinical manifestations compared with Lyon (adjusted for follow-up to age 3 years) were: Austria 0.19 (0.04, 0.51); Denmark 0.60 (0.13, 1.08); and The Netherlands 1.46 (0.51, 2.72). There was no clear evidence that the risk of transmission or of clinical manifestations was lowest in centres with the most intensive prenatal treatment.
Gilbert
R
R
Department of Epidemiology and Public Health, Institute of Child Health, London, UK.
Dunn
D
D
Wallon
M
M
Hayde
M
M
Prusa
A
A
Lebech
M
M
Kortbeek
T
T
Peyron
F
F
Pollak
A
A
Petersen
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D004463:Ecology; D005260:Female; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011295:Prenatal Care; D012306:Risk; D015572:Spiramycin / Q000627:therapeutic use*; D014125:Toxoplasmosis, Congenital / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*
D000900:Anti-Bacterial Agents; D015572:Spiramycin