RUNNING TITLE: CONGENITAL TOXOPLASMOSIS TITLE: CONGENITAL TOXOPLASMOSIS IN A PRENATAL CARE STATE PROGRAM Authors:

Background: To evaluate whether the treatment of the pregnant women associated with a lack of monitoring for toxoplasmosis seroconversion affected the prognosis of the patients Methods: Cohort study with 292 newborns at risk for congenital toxoplasmosis, in Goiânia-GO (Brazil), between October 2003 until October 2011. We carried out statistical analysis in order to test the efficacy of maternal treatment with spiramycin. Results and discussion: 40.74% were born seriously affected. Mother-tochild transmission associated with reactivation during pregnancy occurred in 4.94% (8/162), 25% showed a severe infection. The presence of specific immunoglobulins (fetal IgM and IgA) suggested the worst prognosis. The treatment of pregnant women resulted in an asymptomatic condition in the newborns and it also protected against the severity of the disease. The children of untreated patients showed the worst outcome. The fetal IgM was associated to an ocular impairment in 48% of the fetus and the neonatal IgA-specific was related to neuro-ophthalmologic and systemic forms. The maternal treatment with spiramycin decreased significantly the incidence of the most severe modalities of the disease. Conclusion – It is necessary to enhance primary prophylactic measures and to improve the secondary prophylaxis in order to treat the fetus. PALAVRAS CHAVE Congenital Toxoplasmosis; Toxoplasmosis during pregnancy; Treatment of pregnant women with acute toxoplasmosis.