Prenatal Treatment for Serious Neurological Sequelae of Congenital Toxoplasmosis An Observational Prospective Cohort Study 英文参考文献.docVIP

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Prenatal Treatment for Serious Neurological Sequelae of Congenital Toxoplasmosis An Observational Prospective Cohort Study 英文参考文献.doc

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Prenatal Treatment for Serious Neurological Sequelae of Congenital Toxoplasmosis An Observational Prospective Cohort Study 英文参考文献

PrenatalTreatmentforSeriousNeurologicalSequelaeof CongenitalToxoplasmosis:AnObservationalProspective CohortStudy MarioCortina-Borja1,HooiKuanTan1,MartineWallon2,MalgorzataPaul3,AndreaPrusa4 ,Wilma Buffolano5,GunillaMalm6,AlisonSalt7,KatherineFreeman8,EskildPetersen9,RuthE.Gilbert1*, forTheEuropeanMulticentreStudyonCongenitalToxoplasmosis(EMSCOT) 1CentreforPediatricEpidemiologyandBiostatistics,UCLInstituteofChildHealth,London,UnitedKingdom,2HospicesCivilsdeLyon,ServicedeParasitologie,Ho?pital delaCroix-Rousse,Lyon,France,3DepartmentandClinicofTropicalandParasiticDiseases,UniversityofMedicalSciences,Poznan,Poland,4MedicalUniversityofVienna, DepartmentofPaediatricsandAdolescentMedicine,DivisionofPaediatricNeonatology,IntensiveCareandNeuropaediatrics,Vienna,Austria,5PerinatalInfectionUnit, DepartmentofPediatrics,UniversityofNaplesFedericoII,Naples,Italy,6DepartmentofClinicalScience,InterventionandTechnology,KarolinskaInstitutet,Divisionof Paediatrics,KarolinskaUniversityHospital,Huddinge,Sweden,7WolfsonCentre,UCLInstituteofChildHealth,London,UnitedKingdom,8DepartmentofEpidemiology andPopulationHealth,AlbertEinsteinCollegeofMedicine,Bronx,NewYork,UnitedStatesofAmerica,9DepartmentofInfectiousDiseases,AarhusUniversityHospital, Skejby,AarhusN.,Denmark Abstract Background: The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD) of congenital toxoplasmosisisnotknown. MethodsandFindings:Congenitaltoxoplasmosiswasprospectivelyidentifiedbyuniversalprenatalorneonatalscreening in14Europeancentresandchildrenwerefollowedforamedianof4years.Weevaluateddeterminantsofpostnataldeath orSNSDdefinedbyoneormoreoffunctionalneurologicalabnormalities,severebilateralvisualimpairment,orpregnancy terminationforconfirmedcongenitaltoxoplasmosis.Two-thirdsofthecohortreceivedprenataltreatment(189/293;65%). 23/293(8%)fetusesdevelopedSNSDofwhichninewerepregnancyterminations.Prenataltreatmentreducedtheriskof SNSD. The odds ratio for prenatal treatment, adjusted for gesta