Online Program

Maternal toxoplasmosis and adverse pregnancy outcomes

Tuesday, November 5, 2013

Mulubrhan Mogos, PhD, Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health, Tampa, FL
Jason L. Salemi, MPH, Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health, Tampa, FL
Dawood Sultan, Ph.D., Investigaciones Traslacionales, Soluciones Logísticas y Estratégicas de Panamá, Panama, Panama
Hamisu Salihu, MD, PhD, Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health, Tampa, FL
Background: Although toxoplasmosis is considered a mild health problem, women infected during pregnancy, especially during first trimester, may be at higher risk of adverse perinatal outcomes. Methods: We conducted a population-based, retrospective cohort study on infants born alive to Florida-resident women from 1998-2009 (N=2,328,630) using a linked dataset. Maternal toxoplasmosis was identified using International Classification of Diseases, 9th Edition (ICD-9) diagnosis codes of 130.0 through 130.9. Socio-demographic and perinatal outcomes were collected from birth certificates and ICD-9 codes, respectively. Descriptive statistics were used to compare characteristics of women with and without toxoplasmosis. Logistic regression was used to assess the association between toxoplasmosis and selected adverse birth outcomes. We also assessed maternal/infant hospitalization charges by toxoplasmosis status. Results: The rate of toxoplasmosis was 2.75 per 100,000 live births. Highest rates were observed in Hispanic women, born in Central/South America, of advanced age (>35), nulliparous, with lower education, and who used alcohol, tobacco, and/or drugs. Women diagnosed with toxoplasmosis were more likely to have inadequate antenatal care, pregnancy-related complications, undergo cesarean section, and give birth to an infant that was preterm (odds ratio [OR]: 1.74), low birth weight (OR: 1.57), small-for-gestational age (OR: 1.71) or born with a birth defect (OR: 1.93). The median, per-patient maternal and infant hospitalization charges at birth for a mother with toxoplasmosis were higher those without toxoplasmosis (maternal: $10,632 vs. $9,286, p=0.02; infant: $2,436 vs. $1,882, p<0.01). Conclusions: Toxoplasmosis during pregnancy is associated with adverse fetal birth outcomes and increased cost of maternal and infant inpatient care.

Learning Areas:

Public health or related research

Learning Objectives:
Describe factors associated with toxoplasmosis diagnosis during pregnancy. Identify demographic, behavioral, and clinical conditions associated with adverse birth outcomes. Discuss the importance of prenatal care and the consequences of not getting screening and/or treated for toxoplasmosis.

Keyword(s): Infectious Diseases, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am postdoctoral fellow at the University of South Florida with a Masters degree in child health nursing and a Ph.D. in nursing. I have participated on several state and federal grants related to maternal morbidities and pregnancy outcomes. My current research focuses on the impact of gynecological cancers during pregnancy on maternal and fetal birth outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.