Serology of toxoplasma gondii among pregnant women; observational retrospective

Serology of Toxoplasma Gondii Among Pregnant Women; Observational Retrospective Objective: Acute toxoplasma infection during pregnancy poses a risk for congenital toxoplasmosis. Unless the pre-pregnancy serological conditions are not known, it becomes difficult to distinguish between acute and previous infections during pregnancy. In our study, we aimed to evaluation of Toxoplasma gondii IgM seropositive at pregnant women and examination of the diagnosis of seropositive patients, determine the cut-off values for Anti-T.gondii IgM and Anti-T.gondii IgG avidity, analysis of treatments, investigate whether the fetal USG results and the first examination findings of the postnatal babies are diagnosed with congenital toxoplasma. Material and Method: The study was performed retrospectively in our hospital between 01.01.2010-31.12.2018. We accepted 195 pregnant women who were anti T.gondii IgM positive. Anti- T.gondii IgM titer, anti- T.gondii IgG, anti- IgG avidity index results of these pregnant women were evaluated. Clinical and laboratory information of the patients were accessed from the patient file records in the hospital electronic information management system and patients who were not followed up were accessed by phone. Results: The mean age of the patients included in the study was 28.3 ± 5.1 years. In the study, 24 (12.3%) pregnant women were diagnosed with acute toxoplasmosis, 40 (20.5%) pregnant women with suspected acute toxoplasmosis, and 131 (67.2%) pregnant women with previous toxoplasmosis. Anti- T.gondii IgM values were 6.0 ± 9.9 COI(cut-off index) in the group diagnosed with acute and suspected acute toxoplasmosis, and 1.4 ± 1.3 COI in the group diagnosed with previous toxoplasmosis (p <0.001). The cut-off value of the anti-T.gondii IgM titer for the diagnosis of acute toxoplasma was determined as 1.9 COI by ROC analysis. Pregnant women with anti-T.gondii IgM> 1.9 COI were 10.3 times higher probability to have acute or suspected toxoplasmosis (p <0.001). Low avidity index was found in 54 (27.7%) of the pregnant women, borderline avidity index in 21 v (10.8%), and high avidity index in 83 (42.6%). Pregnant women with anti-T.gondii IgG Avidity index <60.0 were 51.6 times higher probability to have acute or suspected toxoplasmosis (p <0.001). 59 of the 195 patients received spiramycin treatment. Amniocentesis was performed on 10 of the 64 patients with acute and suspected acute toxoplasmosis diagnosis, and T.gondii PCR was positive in a pregnant woman. Congenital toxoplasmosis did not develop the baby of the pregnant woman whom amniotic fluid was positive for T.gondii PCR. Congenital toxoplasmosis founded a baby. Conclusion: The cut-off points determined for Anti- T.gondii IgM and Anti- T.gondii IgG avidity values can be a predictive parameter for detecting acute and suspected acute toxoplasmosis. It is important to screen the toxoplasma serology of women before getting pregnancy because of diagnostic difficulty during pregnancy. Preferably, we should be performed at during pre-marital statius.