Long-term outcome of children with congenital toxoplasmosis.
OBJECTIVE
Maternal toxoplasmosis infection acquired during pregnancy carries significant risk of fetal damage. We aimed to assess the long-term outcome of children and young adults with congenital toxoplasmosis diagnosed and treated in utero.


METHODS
This was a 20 year prospective study (1985-2005). All mothers received spiramycin, alone or associated with pyrimethamine-sulfadoxine, and underwent amniocentesis and monthly ultrasound screening. Infected children were followed every 3-6 months.


RESULTS
Of 666 liveborn children (676 mothers), 112 (17%) had congenital toxoplasmosis. Among these, 107 were followed up for 12-250 months: 79 were asymptomatic (74%) and 28 had chorioretinitis (26%). Only 1 child had a serious neurological involvement.


CONCLUSIONS
The percentage of chorioretinitis in treated children depends on length of follow-up, but this complication occurs mainly before the age of 5 years and almost always before the age of 10 years. Visual impairment was infrequently severe, and outcome appears consistently good. Long-term follow-up is recommended to monitor ocular and neurological prognosis, whatever the practical difficulties.
Berrébi
Alain
A
Fédération de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France. berrebi.a@chu-toulouse.fr
Assouline
Corinne
C
Bessières
Marie-Hélène
MH
Lathière
Myriam
M
Cassaing
Sophie
S
Minville
Vincent
V
Ayoubi
Jean-Marc
JM
D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D002825:Chorioretinitis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D018570:Risk Assessment; D015572:Spiramycin / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use; D013997:Time Factors; D014125:Toxoplasmosis, Congenital / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology
D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D015572:Spiramycin; D013413:Sulfadoxine; D011739:Pyrimethamine