[Toxoplasmosis and pregnancy. Multicenter study of 16,362 pregnant women in Barcelona].
OBJECTIVE
The aim of this study was to know: 1) the prevalence of antibodies against toxoplasma in pregnant women, 2) the incidence of primary infection during pregnancy and 3) the prevalence of congenital toxoplasmosis.


METHODS
Seroprevalence was prospectively analyzed in 16,362 pregnant women visited in 8 hospitals and 2 day care centers in Barcelona during 1999. Each participant laboratory included their own assays to detect toxoplasma-specific immunoglobulins IgM, IgA, IgG and IgG avidity antibodies. In case of positive specific IgM, a second serum sample was requested, which was processed in parallel with the first one. Three infection stages were defined: acute, possible and past (latent). Congenital infection was determined prenatally by polymerase chain reaction (PCR) in amniotic fluid or postnatally by serology in the newborn.


RESULTS
Seroprevalence was 28.6%. The incidence of primary infection during pregnancy was 1.02/1,000 susceptible pregnant women. Nine women out of 12 with an acute toxoplasma infection became seroconverted during their pregnancies and five of them had infants with congenital toxoplasmosis (vertical transmission: 41.6%). All four children born alive had no symptoms during their follow-up.


CONCLUSIONS
In this study, the prevalence of toxoplasmosis was low. Acute toxoplasmosis was detected mainly by seroconversion during pregnancy. The frequency of maternal-fetal transmission was near half of cases.
Muñoz Batet
Carme
C
Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. cmunoz@hsp.santpau.es
Guardià Llobet
Cèlia
C
Juncosa Morros
Teresa
T
Viñas Domenech
Lluís
L
Sierra Soler
Montserrat
M
Sanfeliu Sala
Isabel
I
Bosch Mestres
Jordi
J
Dopico Ponte
Eva
E
Lite Lite
Josep
J
Matas Andreu
Lurdes
L
Juste Sánchez
Concha
C
Barranco Romeu
Margarita
M
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology; D014123:Toxoplasmosis / Q000097:blood / Q000453:epidemiology*; D014125:Toxoplasmosis, Congenital / Q000097:blood / Q000453:epidemiology*