Prevention of toxoplasmosis during pregnancy – an epidemiologic survey over 22 consecutive years
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M. Breugelmans
Abstract
Background: Prevention of congenital toxoplasmosis is most often based on the results of a serological screening program in pregnant women followed by prenatal and postnatal treatment of women and their newborns when infection is already established during pregnancy or on cord blood (secondary prevention). Little effort has been made to study primary prevention of toxoplasmosis during pregnancy.
Objective: To assess the possibilities of two different programs aimed at preventing the acquisition of toxoplasmosis during pregnancy.
Methods: During the first study period (1979–1982) the natural incidence of toxoplasmosis in pregnancy was studied in 2986 pregnant women. In the second study period (1983–1990) the incidence of toxoplasmosis was studied in 8300 women. During this period, seronegative women received a written list of recommendations on how to avoid a toxoplasma infection during pregnancy. In the third study period (1991–2001) the incidence of toxoplasmosis was studied in 16541 women. During this period, the prevention campaign consisted of a leaflet explaining a) toxoplasmosis as a disease and b) what measures should be taken to avoid toxoplasmosis during pregnancy. The third part of the campaign involved a reiteration of these recommendations during antenatal classes held around mid-gestation.
The impact of the two prevention programs was studied by measuring the seroconversion rate in seronegative women.
Results: Twenty of 1403 seronegative women in the first period (1.43%), 19 of 3605 women in the second period (0.53%) and 8 of 8492 in the third period (0.09%) seroconverted during pregnancy. The first prevention campaign reduced the seroconversion rate by 63% (p<0.05 OR 2.729 95% CI 1.452–5.084). The second prevention program resulted in a reduction rate of 92% compared to the seroconversion rate in the first period (p<0.0001 OR 15.34 95% CI 6.741–34.89).
Conclusion: Promotion of simple measures is very effective in the prevention of toxoplasmosis during pregnancy. Primary prevention should not only be based on education about preventive measures given by physicians, but these guidelines should be reiterated during antenatal classes and leaflets distributed containing written recommendations on the nature of the disease and its avoidance.
Copyright © 2004 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Second overview of relationships between antenatalpharmacologic magnesium sulfate and neurologic outcomes in children
- Prevention of toxoplasmosis during pregnancy – an epidemiologic survey over 22 consecutive years
- The impact of multiple pregnancies and malformations on perinatal mortality
- Oral nifedipine maintenance therapy after acute intravenous tocolysis in preterm labor
- Perinatal outcome in women with severe pregnancy complications and multiple thrombophilias
- Reproducibility of the study of placental vascularization by three-dimensional power Doppler
- The prevalence of preterm deliveries in Berlin has not changed over 7 years: the impact of multiple births
- Amniotic fluid and cord plasma erythropoietin levels in pregnancies complicated by preeclampsia, pregnancy-induced hypertension and chronic hypertension
- N-Glycans of human amniotic fluid transferrin stimulate progesterone production in human first trimester trophoblast cells in vitro
- Risk factors for fetal-to-maternal transfusion in Rh D-negative women – results of a prospective study on 942 pregnant women
- Does fetal head position at the term plus 12 scan influence induction, labor and delivery outcome?
- Doppler examinations of fetal and uteroplacental blood flow in AGA and IUGR fetuses before and after maternal physical exercise with the bicycle ergometer
- Maternal serum, amniotic fluid and cord leptin levels at term: their correlations with fetal weight
- Intrauterine smoke exposure: a new risk factor for bronchopulmonary dysplasia?
- Effect of Phenobarbital on free radicals in neonates with hypoxic ischemic encephalopathy – a randomized controlled trial
- Increase in cord blood soluble E-selectin and tracheal aspirate neutrophils at birth and the development of new bronchopulmonary dysplasia
- Biliary atresia due to delayed maturation of the gut hormones system? – Introducing a new treatment modality
