Researchers urge prenatal screening for toxoplasmosis.(Obstetrics)

All pregnant women should undergo screening for Toxoplasma gondii infection once each trimester, and all newborns should be screened for congenital toxoplasmosis, Kenneth M. Boyer, M.D., and colleagues have recommended.

Even a thorough history fails to identify about half of pregnant women who have an acute infection, according to Dr. Boyer of Rush University Medical Center, Chicago. Only a serologic screening process would identify all infected women and newborns in time to administer the medical treatment necessary to prevent neurologic sequelae of the illness in these infants (Am. J. Obstet. Gynecol. 2005;192:564-71).

"It is difficult to imagine that any informed mother or father would choose not to include this screening in their prenatal care, considering that almost all untreated infants who are infected ... in utero experience ophthalmologic and/or neurologic disease, and that treatment of the fetus and infant clearly reduces these risks," they said.

The researchers retrospectively analyzed the medical records of 131 infants and children with congenital toxoplasmosis who were referred to the Chicago Collaborative Treatment Trial. The study focused on demographic data and the mothers' understanding of factors surrounding their exposure to the parasite.

The women were questioned about their exposure during pregnancy to cats, cat litter, gardening, and sandboxes. They also were questioned about their consumption of raw or undercooked meat, eggs, or unpasteurized milk, as well as the nature and timing of their exposure; and any illness during pregnancy that was compatible with infection, especially prolonged fever, night sweats, myalgia, headache, and lymphadenopathy.

Most of the women (75%) could recall a conceivable exposure, but only 39% specifically recalled exposure to cat litter or raw meat dishes. One-quarter of the women could not identify any possible exposure to either cats or raw or undercooked foods.

More than half (52%) could not recall an infectious illness of any kind during pregnancy. Almost half (48%) noted an illness that might have been caused by the parasite: 27% recalled fever or night sweats and 23% recalled lymphadenopathy.