title: Evaluation of serological prenatal screening to detect Toxoplasma gondii infections in Austria.
abstract: BACKGROUND
  In Austria, a nationally mandated prenatal serological congenital toxoplasmosis screening program was introduced in 1974 in response to a high incidence of 7.8 per 1,000 infected infants. Maternal prenatal recognition of acute gestational infection and early treatment of infants with congenital infection are important because prenatal and accurate postnatal antibiotic therapy improves the outcomes of infected infants.
  
  
  OBJECTIVE
  To determine the impact of additional maternal and/or fetal cord blood serology at birth on improving current prenatal maternal screening in detecting congenital toxoplasmosis.
  
  
  METHODS
  In this prospective observational study, 5,545 consecutive women were included over a 19-month period. Routine prenatal maternal toxoplasmosis serology screening was performed along with additional cord blood serology screening at delivery. Fetal cord blood serology included Sabin-Feldman dye and IgM immunosorbent agglutination assay testing.
  
  
  RESULTS
  Based on the initial prenatal maternal screening serology results, there was evidence of a prior chronic infection manifest in 1,830 (33.0%) women and 3,708 (66.9%) were not infected. Seven (0.13%) were diagnosed with acute toxoplasma infection based on seroconversion. Of these, 4 manifested transmission, and 3 did not. Of the seven infected women, routine prenatal maternal screening identified acute infection in only 2 of the women, 1 of whom had an infected fetus with abnormal prenatal ultrasound. Fetal cord blood serology screening identified an additional 5 women, 3 with infected fetuses.
  
  
  CONCLUSIONS
  Identification of Toxoplasma gondii infection by prenatal maternal serological testing is significantly improved by the addition of maternal and/or fetal serological testing at birth.
authors.affiliation: Division of Pediatric Neonatology, Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Andrea-Romana
authors.initials: AR
authors.lastname: Prusa
authors.forename: David C
authors.initials: DC
authors.lastname: Kasper
authors.forename: Monika
authors.initials: M
authors.lastname: Olischar
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Arnold
authors.initials: A
authors.lastname: Pollak
authors.forename: Michael
authors.initials: M
authors.lastname: Hayde
mesh_terms: D000328:Adult; D000465:Algorithms; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000379:methods*; D012698:Serologic Tests / Q000706:statistics & numerical data; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D014125:Toxoplasmosis, Congenital / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult