Effect of prenatal treatment on mother to child transmission of Toxoplasma gondii:: retrospective cohort study of 554 mother-child pairs in Lyon, France
Effect of prenatal treatment on mother to child transmission of Toxoplasma gondii:: retrospective cohort study of 554 mother-child pairs in Lyon, France
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DOI：
10.1093/ije/30.6.1303
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发表时间：
2001-12-01
影响因子：
7.7
通讯作者：
Dunn, DT
中科院分区：
文献类型：
--
作者：
Gilbert, RE;Gras, L;Dunn, DT
背景产前弓形虫病血清学筛查的目的是尽早发现和治疗母体感染，以防止弓形虫传播给胎儿。然而，尽管在欧洲广泛提供产前弓形虫筛查，产前治疗的有效性是不确定的。本研究旨在确定的锡-血管紧张素和类型的产前治疗对母婴传播的弓形虫。方法一个队列的554名感染孕妇被确定在里昂，法国在1987年和1995年之间，他们的孩子进行了跟踪，以确定先天性感染状态。我们通过检查母体血清转换和开始治疗之间的延迟来确定产前治疗对传播的影响。我们还比较了治疗类型和不治疗对母婴传播风险的影响。结果与血清转换后4周内治疗相比，延迟4-7周治疗后母婴传播的调整优势比（OR）为1.29（95%CI：0.61，2.73），延迟8周后为1.44（95%CI：0.60，3.31）。与乙胺嘧啶-磺胺嘧啶治疗相比，螺旋霉素单药治疗的校正OR为0.91（95%CI：0.45，1.84），未治疗与乙胺嘧啶-磺胺嘧啶治疗相比的OR为1.06（95%置信区间：0.37,3.03）.结论作者推测，产前治疗效果的缺失是由于治疗开始前的传播。
Background The aim of prenatal serological screening for toxoplasmosis is to identify and treat maternal infection as soon as possible in order to prevent transmission of the parasite to the fetus. However, despite widespread provision of prenatal toxoplasma screening across Europe, the effectiveness of prenatal treatment is uncertain. The study aimed to determine the effect of the tin-Ang and type of prenatal treatment on mother to child transmission of Toxoplasma gondii.Method A cohort of 554 infected pregnant women were identified in Lyon, France between 1987 and 1995 and their children were followed to determine congenital infection status. We determined the effect of prenatal treatment on transmission by examining the effect of the delay between maternal seroconversion and start of treatment. We also compared the effect of the type of treatment and no treatment on the risk of mother to Child transmission. Analyses were adjusted for gestation at maternal seroconversion.Results Compared to treatment within 4 weeks from seroconversion, the adjusted odds ratios (OR) for mother to Child transmission after a treatment delay of 4-7 weeks was 1.29 (95% CI: 0.61, 2.73) and after more than 8 weeks, 1.44 (95% CI: 0.60, 3.31). The adjusted OR associated with spiramycin alone compared with pyrimethamine-sulfadiazine treatment was 0.91 (95% CI: 0.45, 1.84) and the OR for no treatment compared with pyrimethamine-sulfadiazine treatment was 1.06 (95% CI: 0.37, 3.03).Conclusions The authors hypothesize that the absence of an effect of prenatal treatment is due to transmission before the start of treatment.