Current status of prenatal screening for toxoplasmosis in Spain
DOI:
https://doi.org/10.4321/s2173-92772026000300005Keywords:
congenital toxoplasmosis, prenatal screening, pregnancy, maternal-fetal transmission, public health, secondary prevention, epidemiology, SpainAbstract
Background: Congenital toxoplasmosis (CT) is a potentially severe infection whose complications can be prevented through primary, secondary, and tertiary prevention strategies. Prenatal serological screening is the main secondary prevention tool; however, its implementation in Spain is heterogeneous and lacks a common national strategy.
Objective: To review the current status of prenatal toxoplasmosis screening in Spain, including its implementation, the epidemiology of the disease, the evidence regarding the effectiveness of screening and prenatal treatment, and the main challenges to its implementation.
Methodology: Narrative review of the scientific literature on prenatal screening and prevention of congenital toxoplasmosis, with particular attention to evidence from Spain. PubMed/MEDLINE, official institutional documents, and scientific-society recommendations were consulted through August 2026.
Main findings: In 2021, prenatal screening was performed in 53.3% of Spanish hospitals participating in the Spanish Network for Congenital Toxoplasmosis Research (REIV-TOXO), with substantial regional differences. The epidemiology of gestational and congenital toxoplasmosis remains insufficiently characterized, and underdetection is likely. In the REIV-TOXO cohort, 92.8% of subsequently confirmed CT cases had been identified through prenatal screening. Prenatal treatment was associated with a lower risk of neonatal symptoms and subsequent complications; separately, meta-analyses and cohorts of infected pregnant women have reported an association between prenatal treatment and lower maternal-fetal transmission.
Conclusions: Available evidence supports the usefulness of prenatal screening for the early detection of maternal infection and for improving the prognosis of CT. The current situation in Spain justifies reassessing its implementation and strengthening epidemiological surveillance.
Downloads
References
Guarch-Ibáñez B. Caracterización de la situación actual de la toxoplasmosis congénita y de su cribado en España [tesis doctoral]. Girona: Universitat de Girona; 2026.
Wehbe K, Pencole L, Lhuaire M, Sibiude J, Mandelbrot L, Villena I, et al. Hygiene measures as primary prevention of toxoplasmosis during pregnancy: A systematic review. J Gynecol Obstet Hum Reprod. 2022;51(3):102300.
Fuentes I, coord. Toxoplasmosis congénita en España, presente y futuro. Madrid: Instituto de Salud Carlos III, Centro Nacional de Microbiología; 2022.
Picone O, Fuchs F, Benoist G, Binquet C, Kieffer F, Wallon M, et al. Toxoplasmosis screening during pregnancy in France: opinion of an expert panel for the CNGOF. J Gynecol Obstet Hum Reprod. 2020;49(7):101814.
Wallon M, Kieffer F, Peyron F, Mandelbrot L, Garweg JG. Toxoplasmosis. In: Maldonado YA, Nizet V, Barnett ED, Edwards KM, Malley R, Remington JS, Klein JO, editors. Remington and Klein’s Infectious Diseases of the Fetus and Newborn Infant. 9th ed. Philadelphia: Elsevier; 2025. p. 859-951.
Mandelbrot L. Congenital toxoplasmosis: What is the evidence for chemoprophylaxis to prevent fetal infection? Prenat Diagn. 2020;40(13):1693-1702.
Petersen E, Meroni V, Vasconcelos-Santos DV, Mandelbrot L, Peyron F. Congenital toxoplasmosis: should we still care about screening? Food Waterborne Parasitol. 2022;27:e00162.
Lebech M, Andersen O, Christensen NC, Hertel J, Nielsen HE, Peitersen B, et al. Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group. Lancet. 1999;353(9167):1834–7.
Newborn Screening for Congenital Toxoplasmosis [Internet]. 2020 [citado el 19 de agosto de 2026]. Disponible en: https://www.gov.br/conitec/pt-br/midias/consultas/relatorios/en2020/20200915_report516_newbor-screening_congenitaltoxoplasmosis.pdf
Pérez-Muñuzuri A, Cernada M, Sánchez-Redondo MD, Boix H, Martín A, Espinosa-Fernández MG, González-Pacheco N, Fernández-Colomer B, Couce ML; en representación del Comité de Estándares de la Sociedad Española de Neonatología. Gestational screening for toxoplasma infection and neonatal impact. Analysis and position statement of the Spanish Society of Neonatology. An Pediatr (Engl Ed). 2026;104(6):504221.
Sociedad Española de Ginecología y Obstetricia. Control prenatal del embarazo normal. Prog Obstet Ginecol. 2018;61(5):510-527.
Grupo de trabajo de la Guía de Práctica Clínica de Atención en el Embarazo y Puerperio. Guía de Práctica Clínica de Atención en el Embarazo y Puerperio. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2014.
Guarch-Ibáñez B, Carreras-Abad C, Frick MA, Blázquez-Gamero D, Baquero-Artigao F, Fuentes-Corripio I, et al. Results of the REIV-TOXO national survey on prenatal screening for toxoplasmosis in Spain. Enferm Infecc Microbiol Clin (Engl Ed). 2024;42(9):478-483.
Garozzo MT, Garozzo R, Betta P, Cilauro S, Saporito A, D’Amico P, et al. Congenital toxoplasmosis: an observational retrospective study in the Eastern Sicily. Front Pediatr. 2025;13:1597001.
Dalmartello M, Parazzini F, Pedron M, Pertile R, Collini L, La Vecchia C, et al. Coverage and outcomes of antenatal tests for infections: a population based survey in the Province of Trento. Italy J Matern Fetal Neonatal Med. 2019;32(12):2049–55.
Sawers L, Wallon M, Mandelbrot L, Villena I, Stillwaggon E, Kieffer F. Prevention of congenital toxoplasmosis in France using prenatal screening: A decision-analytic economic model. PLoS One. 2022;17(11):e0273781.
Prusa AR, Kasper DC, Sawers L, Walter E, Hayde M, Stillwaggon E. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving. PLoS Negl Trop Dis. 2017;11(7):e0005648.
Exames laboratoriais na Gravidez de Baixo Risco. Norma nº 037/2011 atualizada a 20/11/2013. Serviço Nacional de Saúde.[Internet]. 2013 [citado el 19 de agosto de 2026]. Disponible en:https://normas.dgs.min-saude.pt/wp-content/uploads/2019/09/exames-laboratoriais-na-gravidez-de-baixo-risco.pdf
Baquero-Artigao F, del Castillo-Martín F, Fuentes I, Goncé A, Fortuny C, Fernández-Miranda MC, et al. The Spanish Society of Pediatric Infectious Diseases Guidelines for the diagnosis and treatment of congenital toxoplasmosis. An Pediatr (Barc). 2013;79(2):116.e1–16.
Muñoz Batet C, Guardià Llobet C, Juncosa Morros T, Viñas Domenech L, Sierra Soler M, Sanfeliu Sala I, et al. Toxoplasmosis y embarazo. Estudio multicéntrico realizado en 16.362 gestantes de Barcelona. Med Clin (Barc).2004;123(1):12–6.
Roc ML, Palacin MP, Lomba E, Monforte ML, Rebaje V, Revillo Pinilla MJ. Diagnóstico serológico de los casos de toxoplasmosis congénita. Enferm Infecc Microbiol Clin. 2010;28(8):517–9.
Guarch-Ibáñez B, Argudo-Ramírez A, Carreras-Abad C, Frick MA, Blázquez-Gamero D, Baquero-Artigao F, et al. Using dried blood spots to estimate Toxoplasma gondii seroprevalence in pregnant women in Catalonia, Spain, and to serologically diagnose congenital toxoplasmosis. PLoS Negl Trop Dis. 2026;20(1):e0013881.
Parajó Pazos N, Molares-Vila A, Purriños Hermida MJ, Treviño Castellano MM. Seroprevalence and incidence of Toxoplasma gondii infection in pregnant women in the health care area of Santiago de Compostela (NW Spain): 2015-2022. Enferm Infecc Microbiol Clin (Engl Ed). 2025;43(10):682-687.
Miguel-Vicedo M, Cabello P, Ortega-Navas MC, González-Barrio D, Fuentes I. Prevalence of Human Toxoplasmosis in Spain Throughout the Three Last Decades (1993–2023): A Systematic Review and Meta-analysis. J Epidemiol Glob Health. 2024;14(3):621–637.
Centro Nacional de Epidemiología. Instituto de Salud Carlos III. Informe epidemiológico sobre la situación de la toxoplasmosis congénita en España. Resultados de la notificación a la Red Nacional de Vigilancia Epidemiológica para el año 2022 [Internet]. Madrid: Instituto de Salud Carlos III; 2023 [citado 17 Sep 2026]. Disponible en: https://cne.isciii.es/documents/d/cne/toxoplasmosis-20congenita_renave_2022-pdf
Guarch-Ibáñez B, Carreras-Abad C, Frick MA, Blázquez-Gamero D, Baquero-Artigao F, Fuentes I, et al. REIV-TOXO Project: Results from a Spanish cohort of congenital toxoplasmosis (2015-2022). The beneficial effects of prenatal treatment on clinical outcomes of infected newborns. PLoS Negl Trop Dis. 2024;18(10):e0012619.
SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group; Thiébaut R, Leproust S, Chêne G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007;369(9556):115–22.
Mandelbrot L, Kieffer F, Sitta R, Laurichesse-Delmas H, Winer N, Mesnard L, et al; TOXOGEST Study Group. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018;219(4):386.e1–386.e9.
Montoya JG. Systematic screening and treatment of toxoplasmosis during pregnancy: is the glass half full or half empty? Am J Obstet Gynecol. 2018; 219(4):315–9.
Ribeiro SK, Mariano IM, Cunha ACR, Pajuaba ACAM, Mineo TWP, Mineo JR. Treatment Protocols for Gestational and Congenital Toxoplasmosis: A Systematic Review and Meta-Analysis. Microorganisms. 2025;13(4):723.
Montoya JG, Laessig K, Fazeli MS, Siliman G, Yoon SS, Drake-Shanahan E, et al. A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies. Eur J Med Res. 2021;26(1):143.
Peyron F, Garweg JG, Wallon M, Descloux E, Rolland M, Barth J. Long-term impact of treated congenital toxoplasmosis on quality of life and visual performance. Pediatr Infect Dis J. 2011; 30(7):597–600.
Bollani L, Auriti C, Achille C, Garofoli F, De Rose DU, Meroni V, et al. Congenital Toxoplasmosis: The State of the Art. Front Pediatr. 2022;10:894573.
Linertová R, Torres-Castaño A, Guirado-Fuentes C, Toledo-Chavarri A, Álvarez-De la Rosa M, Abt-Sacks A, et al. Cribado prenatal de toxoplasmosis. Ministerio de Sanidad. Servicio de Evaluación del Servicio Canario de la Salud; 2021. Informes de Evaluación de Tecnologías Sanitarias.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Borja Guarch-Ibáñez
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
El material creado por un autor puede ser distribuido, copiado y exhibido por terceros si se hace referencia a la autoría. No se puede obtener ningún beneficio comercial y las obras derivadas tienen que estar bajo los mismos términos de licencia que el trabajo original
