Importance of congenital toxoplasmosis in the newborn period and childhood

Abstract

Congenital toxoplasmosis is caused by transplacental transmission of Toxoplasma gondii during pregnancy. Although its incidence in Spain is low, it remains a relevant disease because of the severe neurological and ocular sequelae it may cause. The risk of fetal transmission increases with gestational age, whereas disease severity is greater when maternal infection occurs during early pregnancy. Most infected newborns are asymptomatic at birth, making early diagnosis challenging. Clinical manifestations include chorioretinitis, hydrocephalus, intracranial calcifications, and other neurological abnormalities. Neonatal diagnosis relies on a combination of serological, molecular, and immunological follow-up tests, whose interpretation depends on the timing of maternal infection and prenatal treatment. Treatment with pyrimethamine, sulfadiazine, and folinic acid during the first year of life significantly reduces the risk of long-term complications. Because late manifestations, particularly ocular disease, may occur, prolonged multidisciplinary follow-up is essential. Prevention through prenatal diagnosis and treatment, together with appropriate neonatal surveillance, represents the most effective strategy for improving outcomes in affected children.