Toxoplasmosis in pregnancy: special care and nutrition

By (embryologist), (gynecologist), (embryologist) and (psychologist).
Last Update: 03/18/2024

Toxoplasmosis is an infection that usually does not produce serious symptoms in people who have a healthy immune system. In fact, many of them will have passed the disease without realizing it.

However, toxoplasmosis is of particular importance in pregnant women, as it can seriously affect the fetus and/or placenta, even causing miscarriage.

For these reasons, to avoid the risk of infection during pregnancy, specialists recommend following special hygiene and dietary guidelines.

What is toxoplasmosis?

Toxoplasmosis is a parasitic disease caused by the protozoan called Toxoplasma gondii.

A parasite is an organism that lives at the expense of another organism of a different species (the host), feeding on it while weakening it, but without killing it.

Normally, it is cats that contract this disease by ingesting feces or meat from other contaminated animals. The parasite then reproduces in your intestine and ends up in your feces.

In a matter of days, this parasite becomes infectious and is resistant to most disinfectants. Therefore, it is able to live in the soil if the temperature and humidity conditions are optimal for it.

It is important to know that infected cats usually appear to be healthy.

How is it diagnosed?

It should be noted that toxoplasmosis is not spread by direct contact with cats. As mentioned above, the parasite is transmitted through their feces. Therefore, it is important that pregnant women do not handle cat feces.

In addition, it is advisable to keep an eye on these animals in case you have them at home so that they cannot eat raw meat (birds or mice) or be in contact with other stray cats.

Other routes of toxoplasmosis infection include the following:

  • Eating raw or undercooked meats contaminated with the parasite.
  • Eating contaminated and poorly washed vegetables that have been in contact with contaminated soil in which infected animals may have defecated.
  • Drinking contaminated water or unpasteurized raw milk.
  • Blood transfusion from an infected individual to a healthy individual.
  • Vertical transmission: the pregnant mother transmits the parasites to the fetus through the placenta.

Symptoms

Toxoplasmosis is a very common human infection worldwide. However, in most cases, it goes unnoticed because its symptoms are very similar to the flu.

The most common symptoms of toxoplasmosis, which will only occur once in a lifetime, are as follows:

  • Slight swelling of the lymph nodes in the neck with no pain.
  • Headache and muscle pain.
  • Sore throat and fever.
  • Fatigue.

Normally, the parasite remains inside the body indefinitely without causing discomfort, since it remains inactive if the immune system is functioning properly.

Pregnant women may present these same symptoms or even none at all, but the severity of the infection poses the risk of transmitting it to the fetus.

In addition to pregnant women, other people who should be especially careful with toxoplasmosis are those who are immunocompromised, such as AIDS patients.

Risks in pregnancy

If the woman has had toxoplasmosis 6 to 9 months before becoming pregnant, she will already be immunized and there will be no risk of transmission to the fetus.

The problems come when a woman contracts the infection for the first time during pregnancy or a few months before. In this case, the probability of transmitting toxoplasmosis to the fetus is greater the more advanced the gestation:

First trimester
15% risk of transmission.
Second trimester
30% risk of transmission.
Third trimester
60% risk of transmission.

However, the severity of infection in the fetus will be greatest in the earliest stages of pregnancy, i.e., in the first trimester. The reason for this is that the parasite invades the cells and causes lesions in the developing fetal tissues.

The toxoplasmosis parasite can pass from the mother to the fetus through the placenta.

In order to take the necessary measures against toxoplasmosis or to avoid its infection, it is very important that pregnant women take a blood test at the beginning of pregnancy.

As we have said, if the woman has already passed toxoplasmosis, there will be no risk of infection. On the other hand, if you are not immunized, you will need to take the preventive measures discussed below.

How does it affect the baby?

In case of infection of the fetus during pregnancy, the consequences can range from mild to severe. In the first trimester, miscarriage may occur and, in the most severe cases, the death of the baby before birth or shortly after birth.

Babies born with the infection will have what is known as congenital toxoplasmosis congenital toxoplasmosis. Some of the alterations associated with this pathology are the following:

  • Low birth weight.
  • Prematurity.
  • Visual disturbances or blindness.
  • Decreased hearing ability.
  • Hydrocephalus.
  • Jaundice (yellowish skin and eyes).
  • Skin rashes.
  • Lymph node enlargement.
  • Anemia.
  • Motor disorders.
  • Mental retardation.
  • Epilepsy.
  • Learning disabilities.
  • Stroke attacks.

Most infants with congenital toxoplasmosis have none of these symptoms at birth, especially those infected late in pregnancy. However, serious problems may appear months or even years after the baby is born.

Prevention of toxoplasmosis

All women who are pregnant or who intend to become pregnant soon should follow preventive measures to avoid contracting the toxoplasmosis parasite.

Hygienic measures

The guidelines to follow throughout pregnancy, especially when cooking, are as follows:

  • Wash hands with soap before and after handling food, especially raw meat.
  • Do not touch eyes, nose or mouth with dirty hands.
  • Wash kitchen counters, cutting boards and all utensils used after contact with raw meat, poultry and seafood with hot soapy water.
  • Avoid gardening work due to contact with soil where an infected cat may have defecated.
  • Use disposable gloves if there are wounds on the hands for cooking or contact with another possible source of exposure.
  • Keep food away from flies.

By following these recommendations, it is possible to reduce the risk of infection by up to 60%.

Food measures

Pregnant women should follow a special diet and take care of their diet throughout pregnancy for the proper development of the baby, but also to avoid toxoplasmosis. We will now discuss some dietary recommendations:

  • Freeze the meat a few days before cooking.
  • Make the meat very well done, since the toxoplasma parasite dies at 72ºC.
  • Do not eat salt-cured or smoked meat, such as ham or salami. They can be eaten on a baked pizza.
  • Do not eat sausages that have not been cooked.
  • Do not drink raw milk or eggs.
  • Drinking bottled water.
  • Wash and sanitize fruits and vegetables well with products suitable for food hygiene.

Measures for domestic cats

Living with cats during pregnancy is not forbidden, although special care is necessary.

First of all, it would be advisable to check the cat's state of health at the veterinarian. If the cat is healthy, it is important that from now on its diet is exclusively based on special cat food and make sure that it does not eat raw meat.

It would also be ideal if someone else would be in charge of cleaning the cat, especially the litter box. It should be emptied daily because the parasite cysts in the stool are infectious after 24 hours.

It is very unlikely that the cat has parasites in its fur. However, it is always a good idea to wash your hands after playing with them and especially before handling food.

Finally, it is important to prevent the cat from entering the kitchen or living room during meal times.

FAQs from users

What are the risks of detecting toxoplasmosis in pregnancy?

By Óscar Oviedo Moreno M.D. (gynecologist).

Toxoplasmosis is a protozoan called toxoplasma gondii that can affect the newborn through the transplacental route. Depending on the stage at which the infection occurs, so will be its consequences.

If a woman becomes infected with toxoplasmosis during pregnancy, the more advanced the pregnancy is, the more likely it is that the infection will be transmitted to the fetus.

However, if the parasite is transmitted during the first trimester of pregnancy, the consequences are more serious.

Transmission can be prevented by following simple hygiene and dietary guidelines during the months of pregnancy.

Is there any treatment for toxoplasmosis during pregnancy?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Yes, pregnant women who have been infected with toxoplasmosis should take the antibiotic Spiramycin to reduce the probability of transmission to the fetus. On the other hand, in case the fetus is also affected, the appropriate treatment will be Pyrimethamine and Sulfadiazine to reduce the damage to the baby.

After birth, the baby will have to continue with the treatment for at least one year.

How is the diagnosis of toxoplasmosis in the fetus?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

To find out if the fetus has been infected with the parasite, an amniocentesis will be necessary. This test will be performed whenever possible if the mother has the disease.

On the other hand, several ultrasound examinations will also be carried out to visualize if there are fetal anomalies.

¿La toxoplasmosis es una causa de aborto recurrente?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Although in the past this type of infection was associated with repeat miscarriage, today it is no longer included in the battery of infertility tests. It is true that toxoplasmosis can cause miscarriage or fetal death, but once the woman has been immunized, there is no longer a risk for future pregnancies.

Other types of infections such as chlamydia, for example, do cause recurrent miscarriages.

As we have said, it is very important for pregnant women to take care of their health to avoid any risks during the entire pregnancy. If you want to know all the details about this, you can continue reading here: Health in pregnancy.

The prenatal amniocentesis test provides information on whether the fetus has been infected with toxoplasma. To learn more about this test, we recommend you to click here: What is amniocentesis?

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References

D Hill, J P Dubey. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol Infect. 2002 Oct;8(10):634-40. doi: 10.1046/j.1469-0691.2002.00485.x (View)

Joshua A Kochanowsky, Anita A Koshy. Toxoplasma gondii. Curr Biol. 2018 Jul 23;28(14):R770-R771. doi: 10.1016/j.cub.2018.05.035 (View)

Quan Liu, Ze-Dong Wang, Si-Yang Huang, Xing-Quan Zhu. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasit Vectors. 2015 May 28:8:292. doi: 10.1186/s13071-015-0902-6 (View)

Márcia Attias, Dirceu E Teixeira, Marlene Benchimol, Rossiane C Vommaro, Paulo Henrique Crepaldi, Wanderley De Souza. The life-cycle of Toxoplasma gondii reviewed using animations. Parasit Vectors. 2020 Nov 23;13(1):588. doi: 10.1186/s13071-020-04445-z (View)

Nitin Arora, Yoel Sadovsky, Terence S Dermody, Carolyn B Coyne. Microbial Vertical Transmission during Human Pregnancy. Cell Host Microbe. 2017 May 10;21(5):561-567. doi: 10.1016/j.chom.2017.04.007 (View)

Tatiane S Lima, Melissa B Lodoen. Mechanisms of Human Innate Immune Evasion by Toxoplasma gondii. Front Cell Infect Microbiol. 2019; 9: 103(View)

Mechanisms of Human Innate Immune Evasion by Toxoplasma gondii. Front Cell Infect Microbiol. 2019 Apr 16:9:103. doi: 10.3389/fcimb.2019.00103.

FAQs from users: 'What are the risks of detecting toxoplasmosis in pregnancy?', 'Is there any treatment for toxoplasmosis during pregnancy?', 'How is the diagnosis of toxoplasmosis in the fetus?' and '¿La toxoplasmosis es una causa de aborto recurrente?'.

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Authors and contributors

 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Óscar Oviedo Moreno
Óscar Oviedo Moreno
M.D.
Gynecologist
Bachelor's Degree in Medicine & Surgery from the University of Caldas (Colombia). Specialist in Internal Medicine by the Pontificia Universidad Javeriana of Bogotá. Degree standardized in Spain in 2003. Specialist in Gynecology & Obstetrics from the Complutense University of Madrid, with residence at Hospital Clínico Universitario San Carlos de Madrid. Expert in Reproductive Medicine and Certification in Obstetric-Gynecologic Ultrasound (levels I, II and III). More information about Óscar Oviedo Moreno
License: 282858310
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Cristina  Algarra Goosman
Cristina Algarra Goosman
B.Sc., M.Sc.
Psychologist
Graduated in Psychology by the University of Valencia (UV) and specialized in Clinical Psychology by the European University Center and specific training in Infertility: Legal, Medical and Psychosocial Aspects by University of Valencia (UV) and ADEIT.
More information about Cristina Algarra Goosman
Member number: CV16874

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