{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:37:08Z","timestamp":1792791428849,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011544","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000}}],"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015799","name":"Universidade Estadual de Maring\u00e1","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015799","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We evaluate the drug treatment for pregnant women with acute toxoplasmosis to reduce the risk of congenital infection, side effects (prenatal and postnatal treatment in children) and the hazard of discontinuing the infant\u2019s medication.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a prospective cohort study to assess the risks of congenital toxoplasmosis among children born to acutely infected women with and without treatment. We examined the relationship between \"exposed\" and \"infected children\", \"number of infant neutrophils\", \"prenatal\" and \"postnatal treatment\". Factor analysis of mixed data (FAMD) was used to analyze the data. All children started treatment at the hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Findings<\/jats:title>\n<jats:p>Between 2017 and 2021, 233 pregnant women were evaluated at the University Hospital of Maring\u00e1; ninety-four met criteria for acute gestational toxoplasmosis. We followed up 61 children; eleven (18%) had the infection confirmed and 50 (82%) were free of toxoplasmosis (exposed). Children born to untreated mothers have 6.5-times higher risk of being infected; the transmission rate among untreated mothers was 50% versus 8.3% among treated ones. Three decreasing values of immunoglobulin G were a security parameter for stopping the child\u2019s medication in the exposed group (50\/61). Neutropenia was the leading side effect among children and the infected had a 2.7 times higher risk. There was no correlation between maternal use of pyrimethamine and children\u2019s neutropenia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Interpretation<\/jats:title>\n<jats:p>The follow-up of women with acute <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> infection and their children, through a multidisciplinary team, availability of anti-<jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> serology and pre- and post-natal treatments reduced the risk of toxoplasmosis transmission.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011544","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T17:30:05Z","timestamp":1696008605000},"page":"e0011544","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Gestational toxoplasmosis treatment changes the child\u2019s prognosis: A cohort study in southern Brazil"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-552X","authenticated-orcid":true,"given":"Ana Gabriela","family":"Gomes Ferrari Strang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaela Gomes","family":"Ferrar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana L\u00facia","family":"Falavigna-Guilherme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"pntd.0011544.ref001","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1201\/9781003199373-2","article-title":"Biology of Toxoplasma gondii","author":"JP Dubey","year":"2021","journal-title":"Toxoplasmosis of Animals and Humans"},{"issue":"9","key":"pntd.0011544.ref002","doi-asserted-by":"crossref","first-page":"e0222094","DOI":"10.1371\/journal.pone.0222094","article-title":"Knowledge and practices regarding toxoplasmosis in housewives: A cross sectional study in a northern Mexican city","volume":"14","author":"N Vel\u00e1zquez-Hern\u00e1ndez","year":"2019","journal-title":"PLoS One"},{"issue":"8","key":"pntd.0011544.ref003","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.ijpara.2009.02.004","article-title":"Toxoplasmosis: A history of clinical observations","volume":"39","author":"LM Weiss","year":"2009","journal-title":"Int J Parasitol"},{"issue":"7","key":"pntd.0011544.ref004","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/zph.12705","article-title":"Epidemiology of a toxoplasmosis outbreak in a research institution in northern Paran\u00e1, Brazil","volume":"67","author":"T Cabral Monica","year":"2020","journal-title":"Zoonoses Public Health"},{"key":"pntd.0011544.ref005","article-title":"Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview","author":"S Almeria","year":"2020","journal-title":"Res Vet Sci"},{"key":"pntd.0011544.ref006","doi-asserted-by":"crossref","first-page":"105608","DOI":"10.1016\/j.actatropica.2020.105608","article-title":"The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis","volume":"211","author":"A Strang","year":"2020","journal-title":"Acta Trop"},{"issue":"3","key":"pntd.0011544.ref007","doi-asserted-by":"crossref","first-page":"e0008103","DOI":"10.1371\/journal.pntd.0008103","article-title":"The global seroprevalence of anti-Toxoplasma gondii antibodies in women who had spontaneous abortion: A systematic review and meta-analysis","volume":"14","author":"T Nayeri","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0011544.ref008","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens8010024","article-title":"Maternal and Congenital Toxoplasmosis: Diagnosis and Treatment Recommendations of a French Multidisciplinary Working Group","volume":"8","author":"F Peyron","year":"2019","journal-title":"Pathogens"},{"issue":"9167","key":"pntd.0011544.ref009","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/S0140-6736(98)08220-8","article-title":"Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling","volume":"353","author":"D Dunn","year":"1999","journal-title":"Lancet"},{"issue":"7","key":"pntd.0011544.ref010","doi-asserted-by":"crossref","first-page":"501","DOI":"10.2471\/BLT.12.111732","article-title":"The global burden of congenital toxoplasmosis: a systematic review","volume":"91","author":"PR Torgerson","year":"2013","journal-title":"Bull World Health Organ"},{"key":"pntd.0011544.ref011","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1590\/s1678-9946202062046","article-title":"Prospective evalution of pregnant women with suspected acute toxoplasmosis treated in a reference prenatal care clinic at a university teaching hospital in Southern Brazil","volume":"62","author":"FF Evangelista","year":"2020","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"4","key":"pntd.0011544.ref012","doi-asserted-by":"crossref","first-page":"386.e1","DOI":"10.1016\/j.ajog.2018.05.031","article-title":"Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial","volume":"219","author":"L Mandelbrot","year":"2018","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"pntd.0011544.ref013","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1111\/j.1651-2227.2005.tb01844.x","article-title":"Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: a cohort study in 13 European centres","volume":"94","author":"L Gras","year":"2005","journal-title":"Acta Paediatr"},{"issue":"9","key":"pntd.0011544.ref014","doi-asserted-by":"crossref","first-page":"e0221709","DOI":"10.1371\/journal.pone.0221709","article-title":"The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis","volume":"14","author":"C Binquet","year":"2019","journal-title":"PLoS One"},{"issue":"10","key":"pntd.0011544.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000351","article-title":"Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study","volume":"7","author":"M Cortina-Borja","year":"2010","journal-title":"PLoS Med"},{"issue":"2","key":"pntd.0011544.ref016","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-3860","article-title":"Diagnosis, Treatment, and Prevention of Congenital Toxoplasmosis in the United States","volume":"139","author":"YA Maldonado","year":"2017","journal-title":"Pediatrics"},{"issue":"2","key":"pntd.0011544.ref017","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1093\/cid\/ciu724","article-title":"The Austrian Toxoplasmosis Register, 1992\u20132008","volume":"60","author":"AR Prusa","year":"2015","journal-title":"Clinical Infectious Diseases"},{"issue":"6","key":"pntd.0011544.ref018","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s10545-010-9229-9","article-title":"Erratum to: Congenital toxoplasmosis\u2014a report on the Danish neonatal screening programme 1999\u20132007","volume":"33","author":"D R\u00f6ser","year":"2010","journal-title":"Journal of Inherited Metabolic Disease"},{"issue":"2","key":"pntd.0011544.ref019","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/tropej\/fmi072","article-title":"Clinical Validation of a Western Blot Assay for Congenital Toxoplasmosis and Newborn Screening in a Hospital in Armenia (Quindio) Colombia","volume":"52","author":"C. Gallego-Marin","year":"2005","journal-title":"Journal of Tropical Pediatrics"},{"key":"pntd.0011544.ref020","unstructured":"Brasil. lei-14154-26-maio-2021-791392-norma. In: Deputados Cd, editor. https:\/\/www2.camara.leg.br: Brazil Government; 2021."},{"issue":"1","key":"pntd.0011544.ref021","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-69078-9","article-title":"Global, regional, and country seroprevalence of Toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis","volume":"10","author":"JJ Bigna","year":"2020","journal-title":"Scientific Reports"},{"issue":"1","key":"pntd.0011544.ref022","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1590\/S0034-89102007000100005","article-title":"Suspected acute toxoplasmosis in pregnant women","volume":"41","author":"MP Castilho-Pelloso","year":"2007","journal-title":"Rev Saude Publica"},{"key":"pntd.0011544.ref023","author":"Brasil","year":"2018"},{"key":"pntd.0011544.ref024","doi-asserted-by":"crossref","DOI":"10.1201\/b10345","volume-title":"Exploratory Multivariate Analysis by Example Using R","author":"F Husson","year":"2010"},{"issue":"1","key":"pntd.0011544.ref025","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v070.i01","article-title":"missMDA: A Package for Handling Missing Values in Multivariate Data Analysis","volume":"70","author":"J Josse","year":"2016","journal-title":"Journal of Statistical Software"},{"key":"pntd.0011544.ref026","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-14-33","article-title":"Congenital toxoplasmosis and prenatal care state programs","volume":"14","author":"MM Avelino","year":"2014","journal-title":"Bmc Infectious Diseases"},{"issue":"1","key":"pntd.0011544.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41426-018-0164-4","article-title":"Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis","volume":"7","author":"KE Bissati","year":"2018","journal-title":"Emerging Microbes & Infections"},{"issue":"4","key":"pntd.0011544.ref028","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jiac.2021.12.005","article-title":"A prospective cohort study of newborns born to mothers with serum Toxoplasma gondii immunoglobulin M positivity during pregnancy","volume":"28","author":"M Hijikata","year":"2022","journal-title":"J Infect Chemother"},{"issue":"11","key":"pntd.0011544.ref029","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1093\/cid\/cis234","article-title":"Efficacy of rapid treatment initiation following primary Toxoplasma gondii infection during pregnancy","volume":"54","author":"A Hotop","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"12","key":"pntd.0011544.ref030","article-title":"Toxoplasmosis: Current and Emerging Parasite Druggable Targets","volume":"9","author":"RE Hajj","year":"2021","journal-title":"Microorganisms"},{"issue":"6","key":"pntd.0011544.ref031","doi-asserted-by":"crossref","first-page":"e0178203","DOI":"10.1371\/journal.pone.0178203","article-title":"Identification of compounds that suppress Toxoplasma gondii tachyzoites and bradyzoites","volume":"12","author":"Y Murata","year":"2017","journal-title":"PLoS One"},{"key":"pntd.0011544.ref032","doi-asserted-by":"crossref","first-page":"e00036","DOI":"10.1016\/j.fawpar.2019.e00036","article-title":"Treatment of toxoplasmosis: Current options and future perspectives","volume":"15","author":"N Konstantinovic","year":"2019","journal-title":"Food Waterborne Parasitol"},{"key":"pntd.0011544.ref033","doi-asserted-by":"crossref","first-page":"822567","DOI":"10.3389\/fimmu.2022.822567","article-title":"Sulfadiazine Plus Pyrimethamine Therapy Reversed Multiple Behavioral and Neurocognitive Changes in Long-Term Chronic Toxoplasmosis by Reducing Brain Cyst Load and Inflammation-Related Alterations","volume":"13","author":"BL Casta\u00f1o","year":"2022","journal-title":"Front Immunol"},{"issue":"5","key":"pntd.0011544.ref034","doi-asserted-by":"crossref","first-page":"e223","DOI":"10.1097\/INF.0000000000003469","article-title":"Spyramicine and Trimethoprim-Sulfamethoxazole Combination to Prevent Mother-To-Fetus Transmission of Toxoplasma gondii Infection in Pregnant Women: A 28-Years Single-center Experience","volume":"41","author":"D Buonsenso","year":"2022","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"pntd.0011544.ref035","first-page":"439","article-title":"Hematopoiesis during acute Toxoplasma gondii infection in mice","volume":"32","author":"M Petakov","year":"2002","journal-title":"Haematologia"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0011544","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T17:39:00Z","timestamp":1698082740000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011544"}},"subtitle":[],"editor":[{"given":"Hamed","family":"Kalani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,29]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0011544","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0011544","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}