ALTHOUGH many risk factors for stillbirth are out of a woman’s control, others can be changed to help lower the risk. A lot of the risk factors that are known early in pregnancy are changeable. Among these are losing weight, if needed, not smoking and using illegal drugs as well as avoidance of infections like toxoplasmosis.
Toxoplasmosis is an infection caused by the parasite toxoplasma gondii. In non-pregnant women, it doesn’t have many symptoms. In fact, many people will never know that they have had it. Some people may have mild flu-like symptoms.
A few may experience a more long-term illness. But it’s risky during pregnancy because it may harm the baby. It could cause miscarriage, stillbirth or congenital toxoplasmosis in unborn babies.
The actual prevalence of the toxoplasma gondii infection during pregnancy is unknown and varies from one community to another in Nigeria. For instance, researchers found evidence of the infection to be high among women that had spontaneous abortion.
The cross-sectional study of 302 pregnant women with spontaneous abortion, presented at the gynaecological emergency units of Federal Teaching Hospital Gombe and State Specialist Hospital Gombe said that the infection was also higher in women who owned cats and ate grilled meat (suya). It was lower in those that washed fruits and vegetables before consumption. This is in the 2020 edition of the Journal of Advances in Medicine and Medical Research.
In 2015, researchers reported in the Journal of Medical Sciences that at Maiduguri Teaching Hospital, antibody suggestive of past exposure to Toxoplasma gondii infection is high among pregnant women seeking antenatal care at the hospital, too.
Blood samples from 360 pregnant women aged 19 to 42 years analysed, indicated that the infection was significantly higher among women who kept cat pets than those who don’t. Also, pregnant women from urban were more affected than those from rural residential areas. And employed women were more likely to contract primary toxoplasmosis than the unemployed.
In pregnancy, the most common means of acquiring infection are through living with cats/dogs, consuming raw or very under-cooked meats or contaminated water, or exposure to soil (farming or gardening without gloves) or cat faeces.
“There is no doubt that toxoplasmosis can cause miscarriage, and it also has effect on the fetus as well. If you look at Europeans, they have a lot of animals. A lot of patients actually have spontaneous abortion,” said Professor Chris Aimakwu, a consultant obstetrics and gyneacologist, University of Ibadan, said.
According to Professor Aimakwu, in the Nigerian setting, it is not too advisable for individuals to keep pets like cat at home, especially when there is a pregnant woman around because most times, these pets are not vaccinated against infections and people hardly take good care of them.
Despite the low prevalence of toxoplasmosis in Nigeria, Professor Aimakwu declared that still, early diagnosis of toxoplasmosis, especially among females in childbearing age is recommended since the disease can cause miscarriage, stillbirth or congenital toxoplasmosis to their infants when they get pregnant.
Congenital toxoplasmosis can cause severe damages to the fetus brain, hydrocephaly, mental retardation and so on. Individuals with congenital toxoplasmosis are likely to develop other clinical manifestations like toxoplasma encephalitis, schizophrenia and organ dysfunction such as liver cirrhosis.
Dr Funmilola Makanjuola, a medical microbiologist consultant at the University College Hospital (UCH), Ibadan stated that toxoplasmosis is one infection that could be passed through the placenta to the unborn child and the disease can be severe in individuals with compromised immunity.
In addition, the toxoplasma gondii can be found in meat, cat faeces, contaminated drinking water, the soil where cats defecate and unpasteurised goats’ milk. The toxoplasma parasite can infect most birds and warm-blooded animals, including humans.
Cats are the only animals that can have infected faeces. After it catches the infection through eating birds, mice or other raw meat, a cat can shed infectious faeces for about 14 days. But toxoplasmosis cannot be caught by stroking a cat or having a cat as a pet.
Given that the pregnant women had antibodies for the infection, Dr Makanjola said it is not suggestive that they have active forms of the infection.
According to her, if the antibody is from a previous infection, it would not be a problem to the developing baby inside the womb.
Dr Makanjola declared: “Usually, we are worried about pregnant women having it because it is one of the causes of abortion, malformations in babies and adverse pregnancy outcomes in general. It is when the woman has an active infection in pregnancy that it is likely to go through the placenta to affect the baby. However, that you have toxoplasmosis does not mean that the woman must have a miscarriage or still birth.”
So, if pregnant and worried about toxoplasmosis, ask your doctor for a blood test to check the infection. If this detects a recent infection, further tests may be carried out to check if your baby is affected and treatment may be given to reduce the risks of complications.
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