Outcome of toxoplasmosis acquired during pregnancy following treatment in both pregnancy and early infancy.
OBJECTIVE
Congenital toxoplasmosis is associated with clinical dilemmas as untreated infants may have a guarded prognosis and as treatment may induce severe side effects. The aim of this study was to investigate the outcome of infants born to mothers with toxoplasmosis acquired during pregnancy, following administration of appropriate regimens both during pregnancy and early infancy.


METHODS
All 35 infants, born to mothers with toxoplasmosis acquired during pregnancy, and referred to the major Neonatal Department in Crete, Greece, during the 7-year period 1997-2003 were included. All neonates were evaluated soon after birth and on a regular follow-up.


RESULTS
Almost all mothers received spiramycin from diagnosis through labor and 2 received pyrimethamine and sulfadiazine. At birth, infants had IgG antibody titers ranging from 1/1,350 to 1/109,350. All infants initially received pyrimethamine, sulfadiazine and folinic acid but in only 4 cases treatment was continued beyond the second month of life. Transient neutropenia was commonly observed. A follow-up period of 1.2-8.2 years did not reveal any remarkable sequelae.


CONCLUSIONS
Our findings suggest that effective treatment both during pregnancy and early infancy is safe and may contribute to a good outcome of infants born to mothers with toxoplasmosis acquired during pregnancy.
Galanakis
Emmanouil
E
Department of Neonatology, University Hospital of Heraklion, Heraklion, Greece. egalanak@med.uoc.gr
Manoura
Antonia
A
Antoniou
Maria
M
Sifakis
Stavros
S
Korakaki
Eftichia
E
Hatzidaki
Eleftheria
E
Lambraki
Dimitra
D
Tselentis
Yiannis
Y
Giannakopoulou
Christina
C
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis / Q000628:therapy*; D015572:Spiramycin / Q000627:therapeutic use; D014123:Toxoplasmosis / Q000175:diagnosis / Q000628:therapy*; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis / Q000517:prevention & control; D016896:Treatment Outcome
D015572:Spiramycin