{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T15:34:14Z","timestamp":1783956854535,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Toxoplasmosis (TG) is a zoonotic disease that, if contracted during pregnancy, can lead to fetal infection with severe complications. Currently, the only way to prevent maternal infection during pregnancy is to adopt hygiene practices. Our study aimed to evaluate pregnant women\u2019s awareness of TG infection, their knowledge of TG-specific preventive hygiene measures, and factors linked to inadequate knowledge as potential targets for intervention. A prospective survey study was conducted at a university hospital between May and November 2023. A self-administered questionnaire was given to pregnant women. Out of 402 participants, 95.3% were aware that TG could be a potential issue in pregnancy. However, only 22.5% of them were able to identify all four correct hygiene behaviors to prevent TG infection acquisition during gestation. Women with a higher level of education, of European origin, and who had heard of other potentially serious conditions in pregnancy were more likely to have an appropriate level of knowledge about TG. Healthcare professionals and mass media, when employed as sources of information before conception, played a positive role in enhancing pregnant women\u2019s awareness of TG. In conclusion, while pregnant women showed high levels of awareness of TG infection, their knowledge of preventive measures was limited, with only less than one-fourth with appropriate knowledge. This highlights the need for innovative strategies, possibly face-to-face interactions, digital tools, and public health campaigns, to improve the ability of healthcare professionals to deliver accurate and accessible information to reduce the risk of infection acquisition during gestation.<\/jats:p>","DOI":"10.3390\/ijerph22040517","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T13:36:49Z","timestamp":1743169009000},"page":"517","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Limited Knowledge of Toxoplasmosis-Specific Preventive Behaviors in Pregnant Women: A Survey Study in Northern Italy"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1642-8770","authenticated-orcid":false,"given":"Federica","family":"Fernicola","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Colciago","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8178-2440","authenticated-orcid":false,"given":"Giulia","family":"Capitoli","sequence":"additional","affiliation":[{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, School of Medicine and Surgery, University of Milano-Bicocca, 20854 Vedano al Lambro, Italy"},{"name":"Biostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3298-1662","authenticated-orcid":false,"given":"Elisa","family":"Merelli","sequence":"additional","affiliation":[{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, School of Medicine and Surgery, University of Milano-Bicocca, 20854 Vedano al Lambro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Arienti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-2693","authenticated-orcid":false,"given":"Valeria","family":"Poletti De Chaurand","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Scandella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Carli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-7217","authenticated-orcid":false,"given":"Sara","family":"Ornaghi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00436-010-1899-6","article-title":"Toxoplasmagondii: Determinants of tachyzoite to bradyzoite conversion","volume":"107","author":"Skariah","year":"2010","journal-title":"Parasitol. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e12606","DOI":"10.1111\/pim.12606","article-title":"How does toxoplasmosis affect the maternal-foetal immune interface and pregnancy?","volume":"41","author":"Borges","year":"2019","journal-title":"Parasite Immunol."},{"key":"ref_3","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":"Torgerson","year":"2013","journal-title":"Bull. World Health Organ."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"B\u00e9nard, A., Petersen, E., Salamon, R., Ch\u00eane, G., Gilbert, R., Salmi, L.R., and European Toxo Prevention Study Grou (2008). Survey of European programm es for the epidemiological surveillance of congenital toxoplasmosis. Eurosurveillance, 13.","DOI":"10.2807\/ese.13.15.18834-en"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Barros, M., Teixeira, D., Vilanova, M., Correia, A., Teixeira, N., and Borges, M. (2021). Vaccines in Congenital Toxoplasmosis: Advances and Perspectives. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.621997"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e687","DOI":"10.1016\/j.jogc.2018.05.036","article-title":"No. 285-Toxoplasmosisin Pregnancy: Prevention, Screening, and Treatment","volume":"40","author":"Paquet","year":"2018","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_7","unstructured":"Istituto Superiore di Sanit\u00e0 (2024, July 15). Antenatal Care for Uncomplicated Pregnancy. PARTONE. Section 1-Information for Pregnant Women. Section 2-Screening for Infections in Pregnancy. Linea Guida 1\/2023 SNLG, 8, 248 (In Italian). Available online: https:\/\/www.epicentro.iss.it\/itoss\/pdf\/LG-Gravidanza-Fisiologica-Parte1_protetto.pdf."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Peyron, F., L\u2019ollivier, C., Mandelbrot, L., Wallon, M., Piarroux, R., Kieffer, F., Hadjadj, E., Paris, L., and Garcia-Meric, P. (2019). Maternal and Congenital Toxoplasmosis: Diagnosis and Treatment Recommendations of a French Multidisciplinary Working Group. Pathogens, 8.","DOI":"10.3390\/pathogens8010024"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1515\/JPM.2004.039","article-title":"Prevention of toxoplasmosis during pregnancy\u2014An epidemiologic survey over 22 consecutive years","volume":"32","author":"Breugelmans","year":"2004","journal-title":"J. Perinat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1515\/JPM.2000.043","article-title":"Prevention of congenital toxoplasmosis","volume":"28","author":"Foulon","year":"2000","journal-title":"J. Perinat. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Smereka, J., Szarpak, L., Ruetzler, K., Schacham, Y., Smereka, A., Dabrowski, M., Terpilowska, M., Terpilowski, L., and Adam, I. (2018). A multicenter survey on toxoplasmosis knowledgeamong pregnant women in Poland (the TOWER study). BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-2031-7"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/10647440300025512","article-title":"Toxoplasmosis-Related Knowledge and Practices Among Pregnant Women in the UnitedStates","volume":"11","author":"Jones","year":"2003","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pereboom, M.T.R., Manni\u00ebn, J., Spelten, E.R., Schellevis, F.G., and Hutton, E.K. (2013). Observation al study to assess pregnant women\u2019s knowledge and behaviour to prevent toxoplasmosis, listeriosis and cytomegalovirus. BMC Pregnancy Childbirth, 13.","DOI":"10.1186\/1471-2393-13-98"},{"key":"ref_14","first-page":"25389","article-title":"Congenital toxoplasmosis: The importance of implementing clinical practice guidelines","volume":"27","author":"DeMoura","year":"2017","journal-title":"Sci. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15285","DOI":"10.3390\/ijerph121214982","article-title":"Awareness of Cytomegalovirus Infection Among Pregnant Women in Geneva, Switzerland: A Cross-sectional Study","volume":"12","author":"Willame","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1017\/S0950268820002393","article-title":"Toxoplasmosis and knowledge:What do the Italian women know about?","volume":"148","author":"Martini","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_17","unstructured":"Sample Size Calculator (2024, June 26). Calculator. net. Available online: https:\/\/www.calculator.net\/sample-size-calculator.html."},{"key":"ref_18","unstructured":"(2024, July 15). CittadinieICT-Anno. Available online: https:\/\/www.istat.it\/it\/archivio\/282257."},{"key":"ref_19","unstructured":"AMCLIETS (2024, June 30). Percorso Diagnostico\u2018Infezionea Trasmissione Verticale TOXOPLASMAGONDII. rev.2023-08. Available online: https:\/\/www.amcli.it\/documenti\/percorsi-diagnostici\/."},{"key":"ref_20","first-page":"329","article-title":"Ilcontrollodella Toxoplasmosicongenitain Italia: Ilprogettodell\u2019Istituto Superioredi Sanit\u00e0","volume":"35","author":"Angelici","year":"1999","journal-title":"Ann. Ist. Super. Sanit\u00e0"},{"key":"ref_21","unstructured":"ISS (2024, June 15). Linee Guida della Gravidanzafisiologica, SNLG, Available online: https:\/\/www.salute.gov.it\/new\/."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Hamou, S.A., and Laboudi, M. (2021). Ananalytical study on the awareness and practice relating toxoplasmosis among pregnant women in Casablanca, Morocco. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10474-9"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1080\/00365549950163626","article-title":"Risk Factors for Toxoplasma Infection in Pregnancy: A Case-Control Study in France","volume":"31","author":"Baril","year":"1999","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_24","first-page":"241","article-title":"Risk factors for toxoplasmosis in pregnant women in central Italy","volume":"19","author":"Thaller","year":"2011","journal-title":"Infez. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1002\/ijgo.15534","article-title":"Indirect impact of SARS-CoV-2 pandemic onincidence of maternal primary cytomegalovirus and Toxoplasma gondii infection in pregnancy","volume":"166","author":"Vasarri","year":"2024","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_26","first-page":"32","article-title":"Toxoplasmosis prevention knowledge among pregnant women in Minnesota","volume":"88","author":"Ogunmodede","year":"2005","journal-title":"Minn. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"23743735231183578","DOI":"10.1177\/23743735231183578","article-title":"Knowledge, Attitude, and Practiceon Antenatal Care Among Pregnant Women and Its Association with Sociodemographic Factors: A Hospital-Based Study","volume":"10","author":"Bashir","year":"2023","journal-title":"J. Patient Exp."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e18255","DOI":"10.2196\/18255","article-title":"Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gainin Pregnant Women: Systematic Review and Meta-Analysis","volume":"8","author":"Rhodes","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"VanLonkhuijzen, R.M., Rustenhoven, H., DeVries, J.H.M., and Wagemakers, A. (2023). The role of the partnerin the support of a pregnant woman\u2019s healthy diet: An explorative qualitative study. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-06072-9"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Karamolahi, P.F., Khalesi, Z.B., and Niknami, M. (2021). Efficacy of mobile app-based training on health literacy among pregnant women: A randomized controlled trial study. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 12.","DOI":"10.1016\/j.eurox.2021.100133"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lupton, D. (2016). The use and value of digital media for information about pregnancy and early motherhood: A focus group study. BMC Pregnancy Childbirth, 16.","DOI":"10.1186\/s12884-016-0971-3"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., Patel, V., and Haines, A. (2013). The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001362"},{"key":"ref_33","first-page":"156","article-title":"Do Digital Health Interventions Improve Mental Health Literacy or Help-seeking Among Parents of Children Aged 2\u201312 Years? A Scoping Review","volume":"266","author":"Peyton","year":"2019","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e37980","DOI":"10.2196\/37980","article-title":"The Definitions of Health Apps and Medical Apps from the Perspective of Public Health and Law: Qualitative Analysis of an Interdisciplinary Literature Overview","volume":"10","author":"Freye","year":"2022","journal-title":"JMIR mHealth uHealth"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e12768","DOI":"10.1111\/mcn.12768","article-title":"A review of pregnancy iPhone apps assessing their quality, inclusion of behaviour change techniques, and nutritionin formation","volume":"15","author":"Brown","year":"2019","journal-title":"Matern. Child. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejogrb.2024.05.035","article-title":"Prevention, diagnosis and pharmacological treatment of infectionsin pregnancy: Themobile app GAIA! For healthcare providers and patients","volume":"299","author":"Bonaiuti","year":"2024","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/4\/517\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:04:23Z","timestamp":1760029463000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/4\/517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["ijerph22040517"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22040517","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}