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Ecological comparison of the risks of mother-to-child transmission and clinical manifestations of congenital toxoplasmosis according to prenatal treatment protocol

Published online by Cambridge University Press:  28 August 2001

R. GILBERT ,
D. DUNN ,
M. WALLON ,
M. HAYDE ,
A. PRUSA ,
M. LEBECH ,
T. KORTBEEK ,
F. PEYRON ,
A. POLLAK  and
E. PETERSEN
R. GILBERT
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, London, UK
D. DUNN
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, London, UK
M. WALLON
Affiliation:
Service de Parasitologie et de Pathologie Exotique, Hôpital de la Croix Rousse, Lyon, France
M. HAYDE
Affiliation:
Department of Neonatology, University Childrens' Hospital, Vienna, Austria
A. PRUSA
Affiliation:
Department of Neonatology, University Childrens' Hospital, Vienna, Austria
M. LEBECH
Affiliation:
Laboratory of Parasitology, Statens Seruminstitut, Copenhagen, Denmark Department of Gynecology-Obstetrics, University Hospital of Hvidore, Denmark
T. KORTBEEK
Affiliation:
Diagnostic Laboratory for Infectious Disease and Perinatal Screening (LIS), National Institute of Public Health and the Environment, Bilthoven, The Netherlands
F. PEYRON
Affiliation:
Service de Parasitologie et de Pathologie Exotique, Hôpital de la Croix Rousse, Lyon, France
A. POLLAK
Affiliation:
Department of Neonatology, University Childrens' Hospital, Vienna, Austria
E. PETERSEN
Affiliation:
Laboratory of Parasitology, Statens Seruminstitut, Copenhagen, Denmark
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Abstract

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We compared the relative risks of mother-to-child transmission of Toxoplasma gondii and clinical manifestations due to congenital toxoplasmosis associated with intensive prenatal treatment in Lyon and Austria, short term treatment in 51% of Dutch women, and no treatment in Danish women. For each cohort, relative risks were standardized for gestation at seroconversion. In total, 856 mother–child pairs were studied: 549 in Lyon, 133 in Austria, 123 in Denmark and 51 in The Netherlands. The relative risk for mother-to-child transmission compared to Lyon was 1·24 (95% CI: 0·88, 1·59) in Austria; 0·59 (0·41, 0·81) in Denmark; and 0·65 (0·37, 1·01) in The Netherlands. Relative risks for clinical manifestations compared with Lyon (adjusted for follow-up to age 3 years) were: Austria 0·19 (0·04, 0·51); Denmark 0·60 (0·13, 1·08); and The Netherlands 1·46 (0·51, 2·72). There was no clear evidence that the risk of transmission or of clinical manifestations was lowest in centres with the most intensive prenatal treatment.

Type
Research Article
Information
Epidemiology & Infection , Volume 127 , Issue 1 , August 2001 , pp. 113 - 120
Copyright
2001 Cambridge University Press