title: Incidence of maternal Toxoplasma infections in pregnancy in Upper Austria, 2000-2007.
abstract: BACKGROUND
  Despite three decades of prenatal screening program for toxoplasmosis in Austria, population-based estimates for the incidence of maternal infections with Toxoplasma gondii during pregnancy are lacking. We studied the incidence of primary maternal infections during pregnancy in the Federal State of Upper Austria.
  
  
  METHODS
  Screening tests for 63,416 women and over 90,000 pregnancies (more than 84.5% of pregnancies in the studied region) in the time period between 01.01.2000 and 31.12.2007 were analysed. The incidence of toxoplasmosis was estimated indirectly by binomial and directly by interval censored regression.
  
  
  RESULTS
  During the studied period, 66 acute infections (risk of 0.07% per pregnancy) were detected, but only 29.8% of seronegative women were tested at least three times during their pregnancies. The seroprevalence of Toxoplasma antibodies among all tested women was 31%. Indirectly estimated incidence (from differences in prevalence by age) was 0.5% per pregnancy, while directly estimated incidence (interval censored regression) was 0.17% per pregnancy (95% confidence interval: 0.13-0.21%).
  
  
  CONCLUSIONS
  Calculating incidence from observed infections results in severe underreporting due to many missed tests and potential diagnostic problems. Using statistical modelling, we estimated primary toxoplasmosis to occur in 0.17% (0.13-0.21%) of all pregnancies in Upper Austria.
authors.affiliation: Department of Public Health Medicine, School of Public Health, University of Bielefeld, PO Box 10 01 31, D-33501 Bielefeld, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Sagel
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
authors.forename: Rafael T
authors.initials: RT
authors.lastname: Mikolajczyk
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010274:Parasitology / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D014122:Toxoplasma / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan