scholarly journals Incidence of congenital toxoplasmosis in southern Brazil: a prospective study

2003 ◽  
Vol 45 (3) ◽  
pp. 147-151 ◽  
Author(s):  
Liége Mozzatto ◽  
Renato Soibelmann Procianoy
Keyword(s):  
Toxoplasma Gondii ◽  
Gestational Age ◽  
Newborn Infants ◽  
Congenital Toxoplasmosis ◽  
Congenital Infection ◽  
First Trimester ◽  
Laboratory Diagnosis ◽  
Anthropometric Measures ◽  
Maternal Characteristics ◽  
The Town

The study aimed to determine the incidence of congenital infection by Toxoplasma gondii and to describe neonatal and maternal characteristics regarding newborn infants treated at a teaching hospital in the town of Passo Fundo, State of Rio Grande do Sul, Brazil. Cord blood samples collected from 1,250 live newborns were analyzed. The laboratory diagnosis was established by the detection of Toxoplasma gondii IgM using an enzyme linked fluorescent assay. Gestational age, intrauterine growth, anthropometric measures, and prenatal characteristics were assessed. The incidence of congenital toxoplasmosis at birth was 8/10,000 (95%CI 0.2-44.5). Mean birthweight was 3,080 ± 215.56 grams and mean gestational age was 38.43 ± 1.88 weeks. With regard to prenatal care, 58% of the pregnant patients visited their doctors five times or more and 38.9% were serologically tested for toxoplasmosis in the first trimester of pregnancy. The incidence of congenital toxoplasmosis was similar to that found in most studies conducted in our country and abroad. Our study sample is representative of the town of Passo Fundo and therefore it is possible to consider the frequency observed as the prevalence of the disease in this town during the study period.

scholarly journals The development of the Sabin–Pinkerton triad despite prenatal screening for congenital toxoplasmosis

2021 ◽  
Vol 17 (3) ◽  
pp. 270-274
Author(s):  
Urszula Dryja ◽  
◽  
Anna Niwald ◽  
Ewa Majda-Stanisławska ◽  
◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Prenatal Screening ◽  
Congenital Toxoplasmosis ◽  
Congenital Infection ◽  
First Trimester ◽  
Imaging Findings ◽  
Pregnant Mother ◽  
First Trimester Of Pregnancy ◽  
Toxoplasma Gondii Infection ◽  
Antiparasitic Treatment

The paper presents a case of a boy who developed the symptoms of congenital toxoplasmosis: hydrocephalus, retinitis, choroiditis and intracranial calcifications (the Sabin–Pinkerton triad). Despite prenatal screening in the first trimester of pregnancy (in accordance with the guidelines of the Ministry of Health), which indicated the diagnosis of asymptomatic primary Toxoplasma gondii infection in the pregnant mother, no antiparasitic therapy was used. The presented serological and imaging findings, as well as specialist consultations confirm the intensified effects of congenital infection in the child. Although the child was put on anti-toxoplasma therapy immediately after birth, he developed severe psychophysical development disorders. The paper discusses recommendations for maternal diagnosis and antiparasitic treatment that could have prevented the full-blown congenital toxoplasmosis in the described patient.

scholarly journals RHΔgra17Δnpt1 Strain of Toxoplasma gondii Elicits Protective Immunity Against Acute, Chronic and Congenital Toxoplasmosis in Mice

2020 ◽  
Vol 8 (3) ◽  
pp. 352 ◽  
Author(s):  
Qin-Li Liang ◽  
Li-Xiu Sun ◽  
Hany M. Elsheikha ◽  
Xue-Zhen Cao ◽  
Lan-Bi Nie ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Cellular Response ◽  
Protective Efficacy ◽  
Interleukin 2 ◽  
Congenital Toxoplasmosis ◽  
Congenital Infection ◽  
Dense Granule ◽  
Lethal Challenge ◽  
Double Deletion ◽  
Brain Cysts

In the present study, a dense granule protein 17 (gra17) and novel putative transporter (npt1) double deletion mutant of Toxoplasma gondii RH strain was engineered. The protective efficacy of vaccination using RHΔgra17Δnpt1 tachyzoites against acute, chronic, and congenital toxoplasmosis was studied in a mouse model. Immunization using RHΔgra17Δnpt1 induced a strong humoral and cellular response, as indicated by the increased levels of anti-T. gondii specific IgG, interleukin 2 (IL-2), IL-10, IL-12, and interferon-gamma (IFN-γ). Vaccinated mice were protected against a lethal challenge dose (103 tachyzoites) of wild-type homologous (RH) strain and heterologous (PYS and TgC7) strains, as well as against 100 tissue cysts or oocysts of Pru strain. Vaccination also conferred protection against chronic infection with 10 tissue cysts or oocysts of Pru strain, where the numbers of brain cysts in the vaccinated mice were significantly reduced compared to those detected in the control (unvaccinated + infected) mice. In addition, vaccination protected against congenital infection with 10 T. gondii Pru oocysts (administered orally on day 5 of gestation) as shown by the increased litter size, survival rate and the bodyweight of pups born to vaccinated dams compared to those born to unvaccinated + infected dams. The brain cyst burden of vaccinated dams was significantly lower than that of unvaccinated dams infected with oocysts. Our data show that T. gondii RHΔgra17Δnpt1 mutant strain can protect mice against acute, chronic, and congenital toxoplasmosis by balancing inflammatory response with immunogenicity.

scholarly journals A first trimester prediction model for large for gestational age infants: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesca Monari ◽  
Daniela Menichini ◽  
Ludovica Spano’ Bascio ◽  
Giovanni Grandi ◽  
Federico Banchelli ◽  
...  
Keyword(s):  
Prediction Model ◽  
Gestational Age ◽  
Predictive Accuracy ◽  
First Trimester ◽  
University Hospital ◽  
Large For Gestational Age ◽  
Aneuploidy Screening ◽  
Maternal Characteristics ◽  
Targeted Interventions ◽  
Increased Risk

Abstract Background Large for gestational age infants (LGA) have increased risk of adverse short-term perinatal outcomes. This study aims to develop a multivariable prediction model for the risk of giving birth to a LGA baby, by using biochemical, biophysical, anamnestic, and clinical maternal characteristics available at first trimester. Methods Prospective study that included all singleton pregnancies attending the first trimester aneuploidy screening at the Obstetric Unit of the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 503 consecutive women were included in the analysis. The final prediction model for LGA, included multiparity (OR = 2.8, 95% CI: 1.6–4.9, p = 0.001), pre-pregnancy BMI (OR = 1.08, 95% CI: 1.03–1.14, p = 0.002) and PAPP-A MoM (OR = 1.43, 95% CI: 1.08–1.90, p = 0.013). The area under the ROC curve was 70.5%, indicating a satisfactory predictive accuracy. The best predictive cut-off for this score was equal to − 1.378, which corresponds to a 20.1% probability of having a LGA infant. By using such a cut-off, the risk of LGA can be predicted in our sample with sensitivity of 55.2% and specificity of 79.0%. Conclusion At first trimester, a model including multiparity, pre-pregnancy BMI and PAPP-A satisfactorily predicted the risk of giving birth to a LGA infant. This promising tool, once applied early in pregnancy, would identify women deserving targeted interventions. Trial registration ClinicalTrials.gov NCT04838431, 09/04/2021.

scholarly journals Prediction of gestational age with symphysis-fundal height and estimated uterine volume in a pregnancy cohort in Sylhet, Bangladesh

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034942
Author(s):  
Anne C C Lee ◽  
Rachel Whelan ◽  
Nazmun Nahar Bably ◽  
Lauren E Schaeffer ◽  
Sayedur Rahman ◽  
...  
Keyword(s):  
Rural Communities ◽  
Gestational Age ◽  
Health Workers ◽  
Late Pregnancy ◽  
Statistical Modelling ◽  
Abdominal Girth ◽  
Anthropometric Measures ◽  
Maternal Characteristics ◽  
Pregnancy Cohort ◽  
Uterine Volume

ObjectiveTo improve the accuracy of the prediction of gestational age (GA) before birth with the standardised measurement of symphysis-fundal height (SFH), estimation of uterine volume, and statistical modelling including maternal anthropometrics and other factors.DesignProspective pregnancy cohort study.SettingRural communities in Sylhet, Bangladesh.Participants1516 women with singleton pregnancies with early pregnancy ultrasound dating (<20 weeks); 1486 completed follow-up.MethodsSFH and abdominal girth were measured at subsequent antenatal care (ANC) visits by community health workers at 24 to 28, 32 to 36, and/or >37 weeks gestation. An estimated uterine volume (EUV) was calculated from these measures. Data on pregnancy characteristics and other maternal anthropometrics were also collected.Primary outcome measureGA at subsequent ANC visits, as defined by early ultrasound dating.Results1486 (98%) women had at least one subsequent ANC visit, 1102 (74%) women had two subsequent ANC visits, and 748 (50%) had three visits. Using the common clinical practice of approximating the GA (in weeks) with the SFH measurement (cm), SFH systematically underestimated GA in late pregnancy (mean difference −4.4 weeks, 95% limits of agreement −12.5 to 3.7). For the classification of GA <28 weeks, SFH <26 cm had 85% sensitivity and 81% specificity; and for GA <34 weeks, SFH <29 cm had 83% sensitivity and 71% specificity. EUV had similar diagnostic accuracy. Despite rigorous statistical modelling of SFH, accounting for repeated longitudinal measurements and additional predictors, the best model without including a known last menstrual period predicted 95% of pregnancy dates within ±7.4 weeks of early ultrasound dating.ConclusionsWe were unable to predict GA with a high degree of accuracy before birth using maternal anthropometric measures and other available maternal characteristics. Efforts to improve GA dating in low- and middle-income countries before birth should focus on increasing coverage and training of ultrasonography.Trial registration numberNCT01572532

Toxoplasma gondii

1990 ◽  
Vol 11 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Deborah J. Zygmunt
Keyword(s):  
United States ◽  
Toxoplasma Gondii ◽  
Mammalian Species ◽  
Congenital Toxoplasmosis ◽  
Immune Deficiency Syndrome ◽  
First Trimester ◽  
The United States ◽  
Deficiency Syndrome ◽  
Immunocompromised Patients ◽  
Acute Toxoplasmosis

Toxoplasma gondii is an obligate intracellular parasite that is a worldwide cause of infections in virtually all mammalian species, including humans. Although toxoplasmosis is extremely common in humans, most cases are subclinical and are revealed only by the presence of antibodies to this parasite. Prior to the use of immunosuppresive therapy and the recognition of the acquired immune deficiency syndrome (AIDS), the most devastating consequence of toxoplasmosis was seen in children of women who acquired acute toxoplasmosis in their first trimester of pregnancy.In the past two decades, this pathogen has become increasingly recognized in immunocompromised patients as a common cause of encephalitis. The tragedy of toxoplasmosis is that it is a preventable disease. French investigators, have clearly defined the risk and range of severity of congenital toxoplasmosis, the value of systemic screening and patient education, and the value of treatment of the mother during pregnancy to prevent transmission to the fetus. Prevention of a large portion of cerebral toxoplasmosis cases in immunocompromised patients might be possible if congenital toxoplasmosis was better controlled in the United States. The first step in controlling toxoplasmosis in the United States is a better appreciation of this infection.

Predictive values of clinical parameters and biophysical and biochemical markers in the first trimester for the detection of small-for-gestational age fetuses

2021 ◽  
Vol 49 (1) ◽  
pp. 73-79
Author(s):  
Irene Reali Antunes ◽  
Guilherme Antonio Rago Lobo ◽  
Edward Araujo Júnior ◽  
David Baptista da Silva Pares
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Biochemical Markers ◽  
Biochemical Parameters ◽  
Uterine Artery ◽  
First Trimester ◽  
Predictive Values ◽  
Maternal Characteristics ◽  
Group Iii ◽  
Group Ii

AbstractObjectivesTo evaluate the predictive values of maternal characteristics, biophysical parameters (mean arterial pressure [MAP] and Doppler uterine artery measurements), and biochemical parameters (pregnancy-associated plasma protein A [PAPP-A] and placental growth factor [PlGF]) alone and in association for small-for-gestational age (SGA) fetuses.MethodsWe performed a retrospective analysis of a prospective observational study that evaluated 615 pregnant women in the first trimester using ultrasonography. For all the women, information regarding clinical and obstetric histories, MAP, and uterine artery mean pulsatility index (UtA-PI), and blood samples for analysis of biochemical markers (PAPP-A and PlGF) were obtained. The patients were grouped according to birth weight as follows: group I (n=571), >10th percentile (control); group II (n=44), <10th percentile; and group III (n=34), <5th percentile. The predictive values of the variables for the detection of SGA fetuses were calculated using a logistic regression model and an analysis of the area under the receiver-operating characteristic curve (AUC).ResultsThe sensitivity rates of the maternal characteristics, biophysical markers (MAP and UtA-PI), biochemical markers (PAPP-A and PlGF), and the association between them were: 23.3, 32.5, 25, and 30% respectively, at a false-positive (FP) rate of 10%, in group II and 26.5, 26.5, 23.5, and 23.5%, respectively, at a FP rate of 10% in group III.ConclusionsThe predictive performances of the combination of maternal characteristics and biophysical and biochemical parameters were unsatisfactory, with a slight improvement in the predictive capacity for SGA fetuses <10th percentile.

scholarly journals Seroprevalence of Toxoplasmosis in Pregnant Women Attending Antenatal Care at Sir Yahaya Memorial Hospital, Birnin Kebbi, Northwestern Nigeria

2020 ◽  
Vol 1 (1) ◽  
pp. 73-76
Author(s):  
Nuhu Hussaini Shehu ◽  
Abdullahi Alhaji Magaji ◽  
Abdulkadir Usman Junaidu ◽  
Abubakar Abubakar Panti ◽  
Makun Babazhitsu
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Congenital Toxoplasmosis ◽  
Congenital Infection ◽  
Protozoan Parasite ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Memorial Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional

Background: Toxoplasmosis is a protozoan infection caused by infection with the obligate intracellular protozoan parasite Toxoplasma gondii (T. gondii). Several studies have been reported of high seroprevalence of this parasite from various hospitals in Nigeria. Aim: The aim of this study was to determine the seroprevalence of toxoplasmosis among the pregnant women receiving antenatal care in Sir Yahaya Memorial Hospital, Birnin Kebbi. Methodology: This was a cross sectional study conducted at SYMH Birnin kebbi in 2015 using indirect Enzyme Linked Immunosorbent Assay (ELISA). Results: The overall seroprevalence of anti-Toxoplasma antibodies was 33.3%. 9.7% seropositivity was found at first trimester, 60.5% from second trimester and 29.8% from third trimester. Using a chi square logistic regression analysis, lack of education, lower age at pregnancy, and frequency of close contacts with cats were significantly associated with the prevalence of IgG antibodies. Conclusion: Most primary infections during pregnancy are asymptomatic, congenital toxoplasmosis can have serious effects on the developing fetus. Screening for primary infection is problematic, primary prevention is the most logical method to lower the risk of congenital infection. There is also a need to educate women on the safe handling of cat litter during pregnancy.

scholarly journals Estimating gestational age at birth: a population-based derivation-validation study

2011 ◽  
Vol 31 (3) ◽  
pp. 103-108 ◽  
Author(s):  
ML Urquia ◽  
TA Stukel ◽  
K Fung ◽  
RH Glazier ◽  
JG Ray
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Infant Health ◽  
Linear Regression Analysis ◽  
Newborn Infants ◽  
Epidemiological Studies ◽  
Administrative Databases ◽  
Discriminative Ability ◽  
Maternal Characteristics ◽  
Infant Birth

Introduction Information on newborn gestational age (GA) is essential in research on perinatal and infant health, but it is not always available from administrative databases. We developed and validated a GA prediction model for singleton births for use in epidemiological studies. Methods Derivation of estimated GA was calculated based on 130 328 newborn infants born in Ontario hospitals between 2007 and 2009, using linear regression analysis, with several infant and maternal characteristics as the predictor (independent) variables. The model was validated in a separate sample of 130 329 newborns. Results The discriminative ability of the linear model based on infant birth weight and sex was reasonably approximate for infants born before the 37th week of gestation (r2 = 0.67; 95% CI: 0.65–0.68), but not for term births (37–42 weeks; r2 = 0.12; 95% CI: 0.12–0.13). Adding other infant and maternal characteristics did not improve the model discrimination. Conclusion Newborn gestational age before 37 weeks can be reasonably approximated using locally available data on birth weight and sex.

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