Serological and Molecular Diagnosis of Acute Feto-Maternal Toxoplasmosis in the Southwestern Region of Saudi Arabia

摘要

Primary toxoplasma infection during pregnancy carries a risk of fetal damage. The most frequent challenge encountered is how to determine if a pregnant woman acquired the acute infection during gestation. This study aimed to determine the incidence of acute maternal toxoplasmosis by a reliable method and to estimate the rate of intrauterine transmission. A total of 487 Saudi pregnant women who had attended the three major hospitals in Southwestern region, Saudi Arabia between January 2008 and August 2010 were included in the study. Two blood samples were collected from each woman. Anti-Toxoplasma gondii antibodies (IgM and IgG) were determined by Enzyme-Linked Immunosorbent Assay (ELISA). Cord blood samples were collected from the umbilical cord after delivery and anti-T. gondii IgM and IgA in these samples were also determined by ELISA. Maternal and fetal seropositive samples were confirmed by Polymerase Chain Reaction (PCR). The incidence rate of acute maternal toxoplasmosis during pregnancy was 2%. Anti-T. gondii IgM was found in 2.4% (4/168) while anti-T. gondii IgA was not detected in any. Infants born to mothers who developed acute toxoplasmosis during pregnancy had significantly higher risk (31 fold) of developing congenital toxoplasmosis. Diagnosis of acute maternal toxoplasmosis during pregnancy should rely on the detection of seroconversion or else PCR is mandatory for confirmation. The incidence of acute maternal toxoplasmosis was considerable in this region of Saudi Arabia. Infants born to those mothers had significantly higher risk of developing congenital toxoplasmosis.