# Prevalence and Risk Factors for Congenital Toxoplasmosis in Newborns in the Public Health System in the Eastern Region of the Brazilian Amazon, Northern Tocantins State, Brazil: Retrospective Cohort Study

## TL;DR

This study found a high rate of congenital toxoplasmosis in newborns in northern Brazil, linked to low maternal education and fewer prenatal visits.

## Contribution

The study identifies key risk factors for congenital toxoplasmosis in a specific Brazilian region using a large cohort of neonates.

## Key findings

- 45.4% of neonates had congenital toxoplasmosis.
- Low maternal education (≤8 years) increased transmission risk (OR = 1.5).
- Fewer than six prenatal consultations greatly increased risk (OR = 22.8).

## Abstract

Objective: To determine the prevalence of and risk factors for congenital toxoplasmosis in neonates treated in the public health network of the eastern region of the Brazilian Amazon, northern Tocantins state. Methods: A retrospective cohort study was conducted with neonates born to mothers with gestational toxoplasmosis who received care between 2017 and 2024. The outcome under analysis was positivity for immunoglobulin M in the electrochemiluminescence assay (CLIA). We estimated the prevalence of transplacental infection and respective 95% confidence intervals (95% CI) and its association with risk factors using the odds ratio (or) with a p-value < 0.05 in infected neonates before and after 16 gestational weeks at maternal infection diagnosis. Results: A total of 1142 neonates were surveyed, in which 496 were diagnosed with congenital toxoplasmosis (IgM positive), thus obtaining a prevalence of vertical transmission of 45.4%. The main risk factors for vertical transmission were the mother’s education level equal to or less than eight years, (OR = 1.5; 95% CI 1.2; 2.0) and having less than six prenatal consultations (OR = 22.8; 95% CI 3.0; 172.6). Conclusions: A high prevalence of congenital toxoplasmosis was observed, with higher rates of infection in neonates born to mothers with lower levels of education.