{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:18:12Z","timestamp":1789827492629,"version":"4.0.1"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Prince Sattam bin Abdulaziz University","award":["PSAU\/2023\/R\/1445"],"award-info":[{"award-number":["PSAU\/2023\/R\/1445"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: The protozoan parasite Toxoplasma gondii may cause serious illness in the immunocompromised. The Toxoplasma gondii seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. Objective: The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries\u2019 pregnant women\u2019s seroprevalence of Toxoplasma gondii and the maternal\u2013fetal outcomes. Methods: This quantitative study examined WHO Eastern Mediterranean countries\u2019 maternal\u2013fetal outcomes and Toxoplasma gondii prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of Toxoplasma gondii, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were \u201cToxoplasma gondii\u201d OR \u201cToxoplasma infection\u201d AND \u201cPregnant woman\u201d or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. Results: In total, 95 of 2947 articles meeting the inclusion criteria examined Toxoplasma gondii prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of Toxoplasma gondii in pregnant women was 36.5% (95%CI: 32.6\u201340.4) with a median value of 35.64%, range values of 1.38\u201375.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of Toxoplasma gondii was 33.5% (95%CI: 29.8\u201337.2) with a median value of 33.51%, and a range values of 1.38\u201369.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1\u20134.1)) with a median value of 3.62 and range values of 0.20\u201317.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9\u20134.4) with a median value of 2.05 and a range values of 0.05\u201316.62%. Of the Toxoplasma gondii seropositive women, 1281\/3389 (34.8%) 174\/1765 (32.9%), 1311\/3101 (43.7%), and 715\/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal\u2013fetal outcomes associated with Toxoplasma gondii seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868\/2990 (32.5%), 112\/300 (36.1%), 111\/375 (25.7%), 3\/157 (1.9%) and 96\/362 (20.1%) of women who tested positive for Toxoplasma gondii antibodies. Conclusion: The study found a high proportion of Toxoplasma gondii seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for Toxoplasma gondii infection.<\/jats:p>","DOI":"10.3390\/pathogens12091157","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T21:34:12Z","timestamp":1694554452000},"page":"1157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Seroprevalence, Risk Factors and Maternal\u2013Fetal Outcomes of Toxoplasma gondii in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-9847","authenticated-orcid":false,"given":"Ali A.","family":"Rabaan","sequence":"first","affiliation":[{"name":"Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia"},{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-175X","authenticated-orcid":false,"given":"Leonard Ighodalo","family":"Uzairue","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science, Federal University, Oye-Ekiti 371104, Ekiti State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal H.","family":"Alfaraj","sequence":"additional","affiliation":[{"name":"Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad A.","family":"Halwani","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 47810, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2814-8205","authenticated-orcid":false,"family":"Muzaheed","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulsalam","family":"Alawfi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6861-6934","authenticated-orcid":false,"given":"Amer","family":"Alshengeti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi Arabia"},{"name":"Department of Infection Prevention and Control, National Guard Health Affairs, Prince Mohammad Bin Abdulaziz Hospital, Al-Madinah 41491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawal A.","family":"Al Kaabi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Disease, Sheikh Khalifa Medical City, Abu Dhabi 51900, United Arab Emirates"},{"name":"College of Medicine and Health Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Alawad","sequence":"additional","affiliation":[{"name":"Adult Infectious Diseases Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh 11474, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashael","family":"Alhajri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Alwarthan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer N.","family":"Alshukairi","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 21499, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souad A.","family":"Almuthree","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1741-0933","authenticated-orcid":false,"given":"Roua A.","family":"Alsubki","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9962-9217","authenticated-orcid":false,"given":"Nada N.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, College of Medicine, King Khalid University Medical City, Abha 61481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4045-0810","authenticated-orcid":false,"given":"Mohammed","family":"Alissa","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawra","family":"Albayat","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5968-9303","authenticated-orcid":false,"given":"Tasneem I.","family":"Zaidan","sequence":"additional","affiliation":[{"name":"Pediatric Department, King Abdulaziz Hospital, Jeddah 23831, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Alagoul","sequence":"additional","affiliation":[{"name":"Blood Bank Section, Dammam Regional Laboratory and Blood Bank, Dammam 31411, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Al","family":"Fraij","sequence":"additional","affiliation":[{"name":"Medical Laboratories & Blood Bank Department, Jubail Health Network, Eastern Health Cluster, Ministry of Health, Jubail 35514, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeehan H.","family":"Alestad","sequence":"additional","affiliation":[{"name":"Immunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UK"},{"name":"Microbiology Department, Collage of Medicine, Jabriya 46300, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1017\/S0031182020000967","article-title":"Occurrence of Toxoplasma gondii antibodies and associated risk factors in women in selected districts of Punjab province, Pakistan","volume":"147","author":"AAli","year":"2020","journal-title":"Parasitology"},{"key":"ref_2","first-page":"1","article-title":"Seromolecular assess of Toxoplasma gondii infection in pregnant women and neonatal umbilical cord 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