Long-term outcome of children with congenital toxoplasmosis

• Published in: American journal of obstetrics and gynecology Vol. 203; no. 6; pp. 552.e1 - 552.e6
• Main Authors: Berrébi, Alain, MD, Assouline, Corinne, MD, Bessières, Marie-Hélène, MD, Lathière, Myriam, MD, Cassaing, Sophie, MD, Minville, Vincent, MD, Ayoubi, Jean-Marc, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.12.2010; Elsevier
• Subjects: Age Factors; Biological and medical sciences; Child; Child Development - physiology; Child, Preschool; chorioretinitis; Chorioretinitis - drug therapy; Chorioretinitis - etiology; Chorioretinitis - physiopathology; Cohort Studies; Drug Combinations; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Human protozoal diseases; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Infectious diseases; intracranial lesions; Male; Medical sciences; Monitoring, Physiologic; Obstetrics and Gynecology; Parasitic diseases; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Prospective Studies; Protozoal diseases; Pyrimethamine - therapeutic use; pyrimethamine-sulfadoxine; Risk Assessment; spiramycin; Spiramycin - therapeutic use; Sulfadoxine - therapeutic use; Time Factors; Toxoplasma gondii; Toxoplasmosis; Toxoplasmosis, Congenital - complications; Toxoplasmosis, Congenital - diagnosis; Toxoplasmosis, Congenital - drug therapy; Toxoplasmosis, Ocular - drug therapy; Toxoplasmosis, Ocular - etiology; Toxoplasmosis, Ocular - physiopathology; chorioretinitis; Toxoplasma gondii; pyrimethamine-sulfadoxine; intracranial lesions; pregnancy; spiramycin; Human; Infection; Protozoal disease; Prognosis; Gynecology; Congenital toxoplasmosis; Parasitosis; Child; Long term; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.06.002

Objective Maternal toxoplasmosis infection acquired during pregnancy carries significant risk of fetal damage. We aimed to assess the long-term outcome of children and young adults with congenital toxoplasmosis diagnosed and treated in utero. Study Design This was a 20 year prospective study (1985-2005). All mothers received spiramycin, alone or associated with pyrimethamine-sulfadoxine, and underwent amniocentesis and monthly ultrasound screening. Infected children were followed every 3-6 months. Results Of 666 liveborn children (676 mothers), 112 (17%) had congenital toxoplasmosis. Among these, 107 were followed up for 12-250 months: 79 were asymptomatic (74%) and 28 had chorioretinitis (26%). Only 1 child had a serious neurological involvement. Conclusion The percentage of chorioretinitis in treated children depends on length of follow-up, but this complication occurs mainly before the age of 5 years and almost always before the age of 10 years. Visual impairment was infrequently severe, and outcome appears consistently good. Long-term follow-up is recommended to monitor ocular and neurological prognosis, whatever the practical difficulties.