Garozzo Maria Teresa, Garozzo Rosaria, Betta Pasqua, Cilauro Salvatore, Saporito Alessandro, D'Amico Pietro, Tina Gabriella, Motta Angela, Pulvirenti Alfredo, Alaimo Salvatore, Sciuto Laura, Pecorino Basilio, Ceccarelli Manuela, Scalia Guido, Timpanaro Tiziana, Ruggieri Martino, Polizzi Agata, Praticò Andrea D
Unit of Pediatrics and Pediatric Emergency, Cannizzaro Hospital, Catania, Italy.
Unit of Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Front Pediatr. 2025 Jun 27;13:1597001. doi: 10.3389/fped.2025.1597001. eCollection 2025.
() primary infection during pregnancy can lead to severe consequences in the fetus and newborn, including miscarriage, congenital disease, or neuro-ophthalmological complications.
This study aimed to evaluate the incidence of congenital toxoplasmosis (CT) in a cohort of newborns and assess their neurological, ophthalmological, and auditory sequelae. Additionally, we examined correlations between infection rates, gestational age at maternal seroconversion, prenatal treatment, and postnatal outcomes.
We studied a cohort of 220 newborns evaluated for suspected CT between 2000 and 2021 across three hospitals in Catania, Italy. Prenatal screening identified 98.6% of maternal infections. Collected data included gestational history, neonatal clinical data, and follow-up assessments.
Mother-to-child transmission (MTCT) occurred in 19.2% (29/151) of cases with available follow-up data. MTCT rates increased significantly with gestational age at maternal seroconversion: 5% in the first trimester, 23% in the second, and 63% in the third ( < 0.001). Prenatal treatment administered for ≥28 days was associated with a significantly lower MTCT rate (11.8% vs. 28.6%, = 0.037). No significant association was found between maternal age and the risk of transmission (OR = 1.38, 95% CI: 0.54-3.55; = 0.635). Of the 29 infected newborns, 17 (58.6%) were symptomatic at birth and during the long-term follow-up. Manifestations included microcephaly (10%), intracranial abnormalities (19%), behavioral disturbances (4%), epilepsy (7%), and psychomotor delay (7%). Ophthalmological lesions were present in 21% at birth and 45% during follow-up; no cases of hearing loss were recorded. No significant correlation was observed between gestational age at seroconversion and the presence of clinical symptoms, ocular findings, or neurological sequelae.
Prenatal screening is effective in identifying newborns at risk for CT who require close monitoring and treatment. While our findings align with literature regarding MTCT rates, they differ regarding symptomatic case correlations. Further studies are warranted to better understand the factors influencing disease progression and long-term outcomes.
孕期（）原发性感染可导致胎儿和新生儿出现严重后果，包括流产、先天性疾病或神经眼科并发症。
本研究旨在评估一组新生儿中先天性弓形虫病（CT）的发病率，并评估其神经、眼科和听觉后遗症。此外，我们还研究了感染率、母亲血清转化时的孕周、产前治疗与产后结局之间的相关性。
我们研究了2000年至2021年间在意大利卡塔尼亚的三家医院接受疑似CT评估的220名新生儿队列。产前筛查发现了98.6%的母亲感染病例。收集的数据包括妊娠史、新生儿临床数据和随访评估。
在有可用随访数据的病例中，母婴传播（MTCT）发生率为19.2%（29/151）。MTCT发生率随母亲血清转化时的孕周显著增加：孕早期为5%，孕中期为23%，孕晚期为63%（<0.001）。产前治疗≥28天与显著较低的MTCT发生率相关（11.8%对28.6%，=0.037）。未发现母亲年龄与传播风险之间存在显著关联（OR=1.38，95%CI：0.54-3.55；=0.635）。在29名感染新生儿中，17名（58.6%）在出生时和长期随访期间出现症状。表现包括小头畸形（10%）、颅内异常（19%）、行为障碍（4%）、癫痫（7%）和精神运动发育迟缓（7%）。出生时21%的新生儿有眼科病变，随访期间为45%；未记录到听力损失病例。血清转化时的孕周与临床症状、眼部表现或神经后遗症的存在之间未观察到显著相关性。
产前筛查对于识别有CT风险、需要密切监测和治疗的新生儿是有效的。虽然我们的研究结果与关于MTCT发生率的文献一致，但在症状性病例相关性方面有所不同。有必要进行进一步研究，以更好地了解影响疾病进展和长期结局的因素。
