Kravetz Jeffrey
Yale University, New Haven, CT, USA.
BMJ Clin Evid. 2013 Aug 29;2013:0906.
Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy. About five per 1000 non-immune pregnant women may acquire toxoplasma infection, with a 10% to 100% risk of transmission to the baby. Risks of transmission to the baby are higher later in pregnancy, but risks of infection causing harm to the baby are greater earlier in pregnancy.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects on mother and baby of treating toxoplasmosis during pregnancy to reduce risk of vertical transmission and treat fetal infection? What are the effects of treating toxoplasmosis in neonates infected with toxoplasmosis prenatally? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found six systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiparasitic drugs in pregnancy, and antiparasitic drugs in neonates.
在免疫功能正常的人群中，弓形虫感染通常无症状或症状轻微，并能产生终身免疫，但在孕期可能会产生严重后果。每1000名未免疫的孕妇中约有5人可能感染弓形虫，胎儿被感染的风险为10%至100%。孕期后期胎儿被感染的风险更高，但孕期早期感染对胎儿造成伤害的风险更大。
我们进行了一项系统综述，旨在回答以下临床问题：孕期治疗弓形虫病以降低垂直传播风险并治疗胎儿感染，对母婴会有什么影响？对产前感染弓形虫的新生儿进行弓形虫病治疗会有什么效果？我们检索了：截至2013年6月的医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆及其他重要数据库（《临床证据》综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品和医疗产品监管局（MHRA）等相关组织的危害警示。
我们找到了六项符合我们纳入标准的系统综述、随机对照试验或观察性研究。我们对干预措施的证据质量进行了GRADE评估。
在本系统综述中，我们提供了以下干预措施有效性和安全性的相关信息：孕期使用抗寄生虫药物，以及新生儿使用抗寄生虫药物。
