A meta analysis on risks of adverse pregnancy outcomes in Toxoplasma gondii infection.
OBJECTIVE
Quantified risks of congenital Toxoplasma gondii infection and abnormal pregnancy outcomes following primary maternal infection were evaluated with meta- analysis based on published studies.


METHODS
The related literatures were searched in multiple literature databases regardless of languages. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the risks of vertical transmission of Toxoplasma gondii and abnormal pregnancy outcomes following primary maternal infection with meta-analysis.


RESULTS
53 of the 2632 searched literatures were included in our analysis. The incidence of abnormal pregnancy outcomes in T. gondii infected pregnant women (infected group) was significantly higher than that in the uninfected pregnant women (control group) (OR = 5.10; 95% CI, 3.85-6.75). Toxoplasma gondii infection rate in the abnormal-pregnancy-outcome group was significantly higher than in the normal-pregnancy group (OR = 3.71; 95% CI, 3.31-4.15). The pooled rate of vertical transmission was 20% (95% CI, 15%-26%) in maternal infection of T. gondii. The incidences of vertical transmission in women who were infected in the first, second or third trimester of pregnancy were 5% (95%CI, 2%-16%), 13% (95%CI, 7%-23%), and 32% (95%CI, 24%-41%), respectively. The rates of vertical transmission in women who were treated with spiramycin-only, PSF (pyrimethamine + sulfadiazine + folinic acid) or PS (pyrimethamine + sulfadiazine) combined with spiramycin, or other untypical treatments were 13% (95%CI, 7%-22%), 13%(95%CI, 7%-25%), and 24%(95%CI, 18%-32%), respectively.


CONCLUSIONS
Toxoplasma gondii infection can result in adverse pregnancy outcomes in pregnant women. The pooled rate of vertical transmission was 20% in maternal infection and the incidences of vertical transmission increased in the first, second or third trimester of pregnancy. The pooled rates of transmission in groups treated with spiramycin-only, PSF or PS combined with spiramycin, or other untypical treatments were not significantly different.
Department of Pathogen Biology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, the People's Republic of China.
Xue-Lan
XL
Li
Department of Pathogen Biology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, the People's Republic of China.
Hai-Xia
HX
Wei
Department of Pathogen Biology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, the People's Republic of China; Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital attached to Southern Medical University, Guangzhou, Guangdong, and the People's Republic of China.
Hao
H
Zhang
Department of Pathogen Biology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, the People's Republic of China.
Hong-Juan
HJ
Peng
Department of Biomedical Sciences & Pathobiology, VA-MD Regional College of Veterinary Medicine, Virginia Tech, Duck Pond Drive, Blacksburg, Virginia, United States of America.
David S
DS
Lindsay
D005260:Female; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D012306:Risk; D014123:Toxoplasmosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*