Seroprevalence of toxoplasmosis in pregnant females attending a tertiary care Hospital in Uttar Pradesh, India and its effect on perinatal morbidity and mortality

Abstract

Objective: To document the seroprevalence of toxoplasma in pregnant females attending a tertiary care hospital and to study its effect on perinatal morbidity and mortality. Design: Prospective follow-up study. Setting: Queen Mary's Hospital, a tertiary level hospital affiliated to King George Medical University (earlier known as KGMC), Lucknow, Uttar Pradesh, India. Sample: All pregnant women coming to this hospital for antenatal care in the Obstetrics and Gynaecology Dept. Methods: Pregnant females were selected through systematic random sampling. A pre-tested semi-structured questionnaire was administered. Blood sample was drawn to detect IgM and IgG antibodies against toxoplasma. Delivery outcomes were recorded with reference to abortions, still births, delivery of congenitally malformed baby and gestational age at delivery. Main outcome measures: Perinatal outcomes among those positive for toxoplasma antibodies. Results: Out of 260 subjects screened, 23 (8.8%) were IgM positive and 40 were IgG positive (15.4%). IgM sero-positivity was observed more in females aged >30 years, those =3 gravida, belonging to low socio-economic status, Muslims, those predominantly non-vegetarian and those exposed to raw meat. Still births (17.4% vs. 3.8%; p=0.006), congenital abnormalities (8.7% vs. 0.5%; p=0.002) and abortions (17.4% vs. 2.7%; p=0.001) were more common in those positive for IgM antibodies compared to sero-negatives. Conclusions: Toxoplasma infection plays a role in adverse foetal outcome. Socio-epidemiological aspects constitute an important contributing factor for the spread of the disease. All pregnant women should be educated and counselled for Routine serological testing for toxoplasma-specific antibodies.