American Journal of Epidemiology Vol. 144, No. 4: 405-412
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Risk Factors for Toxoplasma gondii Infection in Pregnancy
Results of a Prospective Case-Control Study in Norway
1Department of Bacteriology, National Institute of Public Health Oslo, Norway
2Section of Food Hygiene, Norwegian College of Veterinary Medicine Oslo, Norway
3Department of Gynecology and Obstetrics, Aker Hospital Oslo, Norway
4Department of Microbiology, Ulleval Hospital Oslo, Norway
5Department of Social Medicine, National Institute of Public Health Oslo, Norway
Reprint requests to Dr. Georg Kapperud, Department of Bacteriology, National Institute of Public Health, P.O. Box 4404, Torshov, N-0403 Oslo, Norway.
From 1992 to 1994, a prospective case-control study designed to identify preventable risk factors for Toxoplasma gondii infection in pregnancy was conducted in Norway. Case-patients were identified through a serologic screening program encompassing 37, 000 pregnant women and through sporadic antenatal testing for Toxoplasma infection. A total of 63 pregnant women with serologic evidence of recent primary T. gondii infection and 128 seronegative control women matched by age, stage of pregnancy, expected date of delivery, and geographic area were enrolled. The following factors were found to be independently associated with an increased risk of maternal infection in conditional logistic regression analysis (in order of decreasing attributable fractions): 1) eating raw or undercooked minced meat products (odds ratio (OR) = 4.1, p = 0.007); 2) eating unwashed raw vegetables or fruits (OR = 2.4, p = 0.03); 3) eating raw or undercooked mutton (OR = 11.4, p = 0.005); 4) eating raw or undercooked pork (OR = 3.4, p = 0.03); 5) cleaning the cat litter box (OR = 5.5, p = 0.02); and 6) washing the kitchen knives infrequently after preparation of raw meat, prior to handling another food item (OR = 7.3, p = 0.04). In univariate analysis, travelling to countries outside of Scandinavia was identified as a significant risk factor, but this variable was not independently associated with infection after data were controlled for factors more directly related to the modes of infection. Am J Epidemiol 1996; 144: 405–12.
case-control studies; pregnancy; risk factors; Toxoplasma; toxoplasmosis
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