بررسی بروز توکسوپلاسموز در نوزادان و عوارض آن

Introduction: Congenital toxoplasmosis is caused by acute toxoplasma gondii infection of mother during pregnancy, which may lead to such serious complications as stillbirth, ophthalmologic and neurologic disorders. The aim of this study was to determine the incidence of toxoplasmosis in pregnant women and their neonates, and disease complications. Methods: In this prospective cohort study, blood samples of 798 pregnant women were assessed for anti-toxoplama IgG and IgM antibodies by ELISA during 2007 -2009. Subjects suffering from acute maternal infection with toxoplasma gondii were considered as case group and those with chronic infection as control group. Nested PCR and ELISA/IgM were performed on four neonates of case group and five samples of control group. Demographic data of mothers and weight and neonates’ gestational age in case(4 subjects) and control groups(28 subjects) were recorded. All infants were followed for clinical symptoms until one year old. Data was entered SPSS and analyzed by Fisher exact test, chi-square and t-test. Results: Five out of 798 pregnant women(0.6%) were positive for IgM 1/100 and suffered from acute toxoplasmosis(case group). Nested PCR showed a 400 bp band in three neonates of case group which confirmed congenital toxoplasmosis, but it was negative in control group(P=0.048). The incidence rate of congenital toxoplasmosis was 3.7 in 1000 live births. Positive ELISA/IgM wasn’t observed in neonates of case and control groups. Only one infant of case group with congenital toxoplasmosis had icterus(P=0.12). Conclusion: Toxoplasmosis in neonates was diagnosed by nested PCR. Icterus was the only sign in infants with toxoplasmosis. In order to prevent this disease, follow–up and treatment of infants, screening of mothers during pregnancy and their health education before pregnancy are suggested.