Prenatal education for congenital toxoplasmosis.
BACKGROUND
Congenital toxoplasmosis is considered a rare but potentially severe infection. Prenatal education about congenital toxoplasmosis could be the most efficient and least harmful intervention, yet its effectiveness is uncertain.


OBJECTIVE
To assess the effects of prenatal education for preventing congenital toxoplasmosis.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2007), CENTRAL (The Cochrane Library 2007, Issue 3), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2007), CINAHL (1982 to November 2007), LILACS (1982 to November 2007) IMEMR (1984 to November 2007), and reference lists of relevant papers, reviews and websites.


METHODS
Randomized and quasi-randomized controlled trials (RCT) of all types of prenatal education on toxoplasmosis infection during pregnancy.


METHODS
Three authors independently assessed study quality and extracted data.


RESULTS
One cluster-randomized controlled trial (432 women) met the inclusion criteria. However, the overall methodological quality was poor. The authors did not report measure of association but only provided P values (P less than 0.05) for all outcomes. The authors concluded that prenatal education can effectively change pregnant women's behavior as it increased pet, personal and food hygiene. There are no randomized trials on the effect of prenatal education on congenital toxoplasmosis rate, or toxoplasmosis seroconversion rate during pregnancy, but three observational studies consistently suggest that prenatal education might have a positive impact on these outcomes.


CONCLUSIONS
Even though primary prevention of congenital toxoplasmosis is considered a desirable intervention, given the lack of related risks compared to secondary and tertiary prevention, its effectiveness has not been adequately evaluated. There is very little evidence from RCTs that prenatal education is effective in reducing congenital toxoplasmosis even though evidence from observational studies suggests it is. Given the lack of good evidence supporting prenatal education for congenital toxoplasmosis prevention, further RCTs are needed to confirm any potential benefits and to further quantify the impact of different sets of educational intervention.
Di Mario
Simona
S
CeVEAS, Centro per la Valutazione della Efficacia della Assistenza Sanitaria, Azienda USL di Modena, V. le L. Muratori 201, Modena, Italy, 41100. s.dimario@ausl.mo.it
Basevi
Vittorio
V
Gagliotti
Carlo
C
Spettoli
Daniela
D
Gori
Gianfranco
G
D'Amico
Roberto
R
Magrini
Nicola
N
D005260:Female; D006801:Humans; D006920:Hygiene; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods*; D014125:Toxoplasmosis, Congenital / Q000517:prevention & control*