494 TOXOPLASMOSIS: MATERNAL AND PEDIATRIC FINDINGS IN 23,000 PREGNANCIES

Abstract

We have studied approximately 23,000 pregnant women and their children from 14 institution located throughout the United States who participated in the Collaborative Perinatal Project. The children were followed for a period of 7 years. Serial serum specimens were available from the pregnant women and these were tested for antibody to toxoplasmosis using a micromodification of the indirect hemagglutination inhi-bition test (IHA). The patients with highest titers (≥1024) or fourfold rises to ≥ 256 by the IHA method were also tested for IgM antibody using indirect fluorescent test (IFA). Among the women tested, 38.6% had detectable antibody and a total of 2.2% of the women showed significant increases in antibody or were in the highest titer ranges. Based on this latter group and the IgM IFA tests, a “High Risk” group of 42 patients was identified. Two of the children had “probable” congenital toxoplasmosis and there were 3 stillbirths. Three other children had abnormalities including prematurity, hypotonia, or short leg which may or may not be related to toxoplasmosis. We also studied the entire population for evidence of abnormal findings which could be corelated with maternal antibody findings using a computer analysis. A total of approximately 240 first year and 300 seven year specific physical and developmental categories were considered. The only outcome indicated to be possibly important was an observed increase in micro-cephaly which was two-fold (.55% versus .24%) among the patients in the higher titer ranges.