No randomised trials identified on treatments for toxoplasmosis in pregnancy.
Toxoplasmosis is a widespread parasitic disease that usually causes no symptoms. However, infection in pregnant women may cause infection in the baby, resulting in possible mental disability and blindness. The risk to the baby is related to the gestational age at the time of infection. The greatest risk of transmission to the baby is during the third trimester, but disease is most severe when it is acquired during the first trimester. In some countries pregnant women are screened for toxoplasmosis by testing for antibodies to the parasite. Women who have no antibodies at the beginning of pregnancy but develop antibodies during pregnancy are considered to have active infection and their babies are at increased risk of toxoplasmosis. Antibiotics (spiramycin and sulphonamide) may be prescribed to try to reduce the risk of mother-to-child transmission, and to reduce the severity of infection in the baby; however these drugs have potential adverse toxic effects. Other countries feel the likelihood of success is too low and to risk the potential adverse effects of the drugs on the baby. Screening programmes will have no impact unless the interventions that are given as a result actually reduce congenital infection and improve infant outcomes. Hence this review sought evidence from randomised controlled trials on the effects of treatments on women who showed signs of toxoplasmosis infection during pregnancy. No randomised controlled trials were identified, so there is no sound evidence on which to base screening and treatment programmes; such evidence is needed and trials of adequate size should be undertaken.