Follow-up of infants with congenital toxoplasmosis detected by polymerase chain reaction analysis of amniotic fluid

This study was conducted to assess the validity of performing the polymeras e chain reaction (PCR) on amniotic fluid for detecting fetal Toxoplasma inf ection. The primary endpoint was the outcome of the infant at 1 year of age . A prospective, consecutive study was performed in 49 infants born to moth ers with primary Toxoplasma infection during pregnancy. PCR determinations of Toxoplasma gondii DNA in amniotic fluid were carried out as part of thei r prenatal management. Infants were examined at birth, and at 1, 3, 6, 9, a nd 12 months of age. Nine of 11 infants from pregnancies with positive PCR results proved to be infected based on follow-up serological investigations conducted during the first year of life. Two fetal deaths occurred. All 38 infants with negative PCR results remained uninfected at 1 year of age, ir respective of whether their mothers had received treatment with sulfadiazin e/pyrimethamine or spiramycin alone. Psychomotor development was normal in all infants. This follow-up study confirms that PCR performed on amniotic f luid is a useful method for identification or exclusion of fetal Toxoplasma infection. Treatment of infected pregnant women and - in the event of a po sitive PCR result subsequent treatment of their infants is associated with a favorable outcome.