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ObjectiveTo evaluate the available information on inflammatory and regulatory plasma mediators in pregnant women (PW) diagnosed with toxoplasmosis. Source: The PubMed, Embase, Scopus, and Lilacs databases were evaluated until October 2022. Study eligibility criteria: This review was carried out following the PRISMA and registered on the PROSPERO platform (CRD42020203951). Studies that reported inflammatory mediators in PW with toxoplasmosis were considered.Evaluation methodsAfter excluding duplicate articles, two authors independently carried out the process of title and abstract exclusion, and a third resolved disagreements when necessary. The full text was evaluated to detect related articles. The extraction table was built from the following data: Author, year of publication, journal name and impact factors, country, study design, number of gestations and maternal age (years), gestational period, diagnosis of toxoplasmosis, levels of inflammatory markers, laboratory tests, and clinical significance. Methodological quality was assessed using Joanna Briggs Institute tools.ResultsOf the 1,024 studies reported, only eight were included. Of the 868 PW included in this review, 20.2% were IgM+/IgG- and 50.8% were IgM-/IgG+ to T. gondii, and 29.0% uninfected. Infected PW presented higher plasma levels ofIL-5, IL-6, IL-8, IL-17, CCL5, and IL-10. Regarding the methodological quality, four studies obtained high quality. Data from this review pointed out the maintenance of the inflammatory pattern during pregnancy with a closely related to the parasite.ConclusionImmune status in PW defined the course of the T. gondii infection, where the equilibrium between inflammatory and regulatory cytokines mitigated the harmful placenta and fetus effects.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420203951.

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BackgroundCongenital toxoplasmosis (CT) is caused by placental transfer of Toxoplasma gondii to the fetus, which can generate neurological, neurocognitive deficits, or death. Appropriate preventive strategies are required for infection-related risk factors. This study assessed the prevalence of T. gondii infection and the factors associated with CT in pregnant women with assistance from the Public Health Service at Ouro Preto, Brazil. MethodsThis cross-sectional study was conducted between April and December 2020. Pregnant women (n=131) aged between 13 and 46 years, were recruited and evaluated for specific IgM/IgG antibody levels against T. gondii. A structured questionnaire was applied to determine the socioeconomic, environmental, gestational, clinical, and dietary patterns. ResultsThe prevalence of T. gondii was 45.8% (n = 60) in which multiparas revealed to be more exposed to infection and were 2.6 times more likely to become infected with the parasite compared to primiparas, (odds ratio, OR=2.60; 95% confidence interval, CI=1.25-5.39). A high prevalence of T. gondii seropositivity was found to be related to the absence of basic sanitation at home. In conclusion, multiparas constitute risk factor for CT. ConclusionsEducational and preventive measures should be intensified in uninfected multiparas to raise awareness about the potential risks of contact with T. gondii.dos Santos PV, de Toledo DNM, Machado BAA, et al. Multiparity as a risk factor for congenital toxoplasmosis: a cross-sectional study.

Background. Congenital toxoplasmosis (CT) is an infectious disease caused by placental transfer of Toxoplasma gondii protozoa to the fetus, and can generate neurological and neurocognitive deficits, or death. As a mother’s infection poses the risk of fetal transmission in about 30% of the cases, appropriate preventive strategies are required for infection-related risk factors. The present study assessed the prevalence of T. gondii infection and the factors associated with congenital toxoplasmosis in pregnant women with assistance from the Public Health Service at Ouro Preto, Brazil.Methods. This cross-sectional study was conducted between April and December 2020. Pregnant women (n = 131) aged between 13 and 46 years, were recruited and evaluated for specific IgM and IgG antibody levels against T. gondii. These women also responded to a structured questionnaire, which was later used to determine the socioeconomic, environmental, gestational, clinical, and dietary patterns.Results. The prevalence of infection by T. gondii was 45.8% (n = 60); of these, multigravida women were more exposed to infection and were 2.6 times more likely to become infected with T. gondii compared to primigravida women (OR: 2.60; 95% CI: 1.25-5.39). A high prevalence of T. gondii seropositivity was identified in pregnant women in the region of Ouro Preto, Brazil, where part of the sample reported the absence of basic sanitation at home.Conclusion. Our data identified multigravida as a potential risk factor for gestational toxoplasmosis, based on the high positivity of anti-T. gondii serology in these women Thus, educational and preventive measures must be intensified in both primigravida and multigravida women, to increase awareness regarding the potential risks of contact with T. gondii.