Prevalence, risk factors, diagnosis and outcomes of Toxoplasma gondii infection in pregnancy: A review

Abstract

Toxoplasmosis, caused by the zoonotic protozoan Toxoplasma gondii, poses substantial risks during pregnancy, including adverse maternal and neonatal outcomes. This review synthesized global evidence on the prevalence, risk factors, diagnostic methods, and clinical consequences of T. gondii infection in pregnant populations. Adhering to PRISMA 2020 guidelines, a literature search of Medline/PubMed and ScienceDirect/Scopus databases (up to February 14, 2025), employed Medical Subject Headings (MeSH) and keywords such as “Toxoplasma gondii,” “pregnancy,” “congenital toxoplasmosis,” and “seroprevalence.” Eligible studies underwent rigorous screening, yielding 18 articles representing diverse regions in Africa, Asia, Latin America, Europe, and North America. Seroprevalence rates varied significantly, from 4.2 % in Mexican cohorts to 71 % in parts of Brazil. Key risk factors included contact with cats, raw/undercooked meat consumption, soil exposure, inadequate hygiene, and unpasteurized milk consumption. Diagnosis primarily relied on serological assays (IgG/IgM ELISA), augmented by molecular techniques (PCR) and IgG avidity testing to identify acute infections. Adverse outcomes such as miscarriage, preterm labour, and congenital toxoplasmosis were consistently reported, though the implications of latent infection remained unclear. These findings underscore toxoplasmosis as a critical public health challenge in pregnancy, necessitating enhanced prenatal screening, refined diagnostic protocols, and targeted education to reduce exposure risks. Longitudinal studies are urged to clarify the effects of latent infection and guide evidence-based interventions globally.