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. 2025 Jun 27:13:1597001.
doi: 10.3389/fped.2025.1597001. eCollection 2025.

Congenital toxoplasmosis: an observational retrospective study in the Eastern Sicily

Maria Teresa Garozzo  1 , Rosaria Garozzo  2 , Pasqua Betta  3 , Salvatore Cilauro  3 , Alessandro Saporito  3 , Pietro D'Amico  4 , Gabriella Tina  5 , Angela Motta  5 , Alfredo Pulvirenti  6 , Salvatore Alaimo  6 , Laura Sciuto  7 , Basilio Pecorino  8 , Manuela Ceccarelli  9 , Guido Scalia  10 , Tiziana Timpanaro  2 , Martino Ruggieri  2 , Agata Polizzi #  2 , Andrea D Praticò #  11
Affiliations

Congenital toxoplasmosis: an observational retrospective study in the Eastern Sicily

Maria Teresa Garozzo et al. Front Pediatr. .

Abstract

Introduction: Toxoplasma gondii (T. gondii) primary infection during pregnancy can lead to severe consequences in the fetus and newborn, including miscarriage, congenital disease, or neuro-ophthalmological complications.

Objectives: 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.

Methods: 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.

Results: 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 (p < 0.001). Prenatal treatment administered for ≥28 days was associated with a significantly lower MTCT rate (11.8% vs. 28.6%, p = 0.037). No significant association was found between maternal age and the risk of transmission (OR = 1.38, 95% CI: 0.54-3.55; p = 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.

Conclusions: 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.

Keywords: congenital toxoplasmosis; gestational age; mother-to-child transmission; neurological sequelae; prenatal screening.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Number of women identified by prenatal screening who seroconverted during first, second and third trimester of gestational age.
Figure 2
Figure 2
Trend of IgM values during the newborns/infants' follow-up.
Figure 3
Figure 3
Trend of IgG values during the newborns/infants' follow-up.
Figure 4
Figure 4
Correlation between trimester of gestational age at seroconversion and prevalence of ocular manifestations.
See this image and copyright information in PMC

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