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Association between congenital toxoplasmosis and preterm birth, low birthweight and small for gestational age birth
Author(s) -
Freeman K.,
Oakley L.,
Pollak A.,
Buffolano W.,
Petersen E.,
Semprini A.E.,
Salt A.,
Gilbert R.
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00299.x
Subject(s) - medicine , obstetrics , gestation , gestational age , birth weight , pregnancy , caesarean section , toxoplasmosis , seroconversion , prospective cohort study , pediatrics , small for gestational age , human immunodeficiency virus (hiv) , immunology , surgery , biology , genetics
Objective To determine the association between congenital toxoplasmosis and preterm birth, low birthweight and small for gestational age birth. Design Multicentre prospective cohort study. Setting Ten European centres offering prenatal screening for toxoplasmosis. Population Deliveries after 23 weeks of gestation in 386 women with singleton pregnancies who seroconverted to toxoplasma infection before 20 weeks of gestation. Deliveries after 36 weeks in 234 women who seroconverted at 20 weeks or later, and tested positive before 37 weeks. Methods Comparison of infected and uninfected births, adjusted for parity and country of birth. Main outcome measures Differences in gestational age at birth, birthweight and birthweight centile. Results Infected babies were born or delivered earlier than uninfected babies: the mean difference for seroconverters before 20 weeks was −5.4 days (95% CI: −1.4, −9.4), and at 20 weeks or more, −2.6 days (95% CI: −0.5, −4.7). Congenital infection was associated with an increased risk of preterm delivery when seroconversion occurred before 20 weeks (OR 4.71; 95% CI: 2.03, 10.9). No significant differences were detected for birthweight or birthweight centile. Conclusion Babies with congenital toxoplasmosis were born earlier than uninfected babies but the mechanism leading to shorter length of gestation is unknown. Congenital infection could precipitate early delivery or prompt caesarean section or induction of delivery. We found no evidence for a significant association between congenital toxoplasmosis and reduced birthweight or small for gestational age birth.