Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children.
BACKGROUND
Information is lacking on the effects of congenital toxoplasmosis on development, behavior, and impairment in later childhood, as well as on parental concerns and anxiety. This information is important for counselling parents about the prognosis for an infected child and for policy decisions on screening.


METHODS
We prospectively studied a cohort of children identified by screening for toxoplasmosis in pregnant women or neonates between 1996 and 2000 in ten European centers. At 3 years of age, parents of children with and without congenital toxoplasmosis were surveyed about their child's development, behavior, and impairment, and about parental concerns and anxiety, using a postal questionnaire.


RESULTS
Parents of 178/223 (80%) infected, and 527/821 (64%) uninfected children responded. We found no evidence that impaired development or behavior were more common in infected children, or that any potential effect of congenital toxoplasmosis was masked by prenatal treatment. Parents of infected children were significantly more anxious and reported more visual problems in their children.


CONCLUSIONS
On average, children aged three to four years with congenital toxoplasmosis identified by screening and treated during infancy in this European setting had risks of abnormal development and behavior similar to uninfected children. Parental anxiety about infected children needs to be addressed by clinicians. Future studies with longer follow up and clinician-administered assessments may be better able to detect any subtle differences in child outcomes.
Freeman
Katherine
K
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA. kfreeman@montefiore.org
Salt
Alison
A
Prusa
Andrea
A
Malm
Gunilla
G
Ferret
Nicole
N
Buffolano
Wilma
W
Schmidt
Dorthe
D
Tan
Hooi Kuan
HK
Gilbert
Ruth E
RE
D001007:Anxiety; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014125:Toxoplasmosis, Congenital / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014786:Vision Disorders / Q000209:etiology