Toxoplasmosis During Pregnancy: Causes, Risks, and Treatment

Toxoplasmosis is an infection that’s easy to overlook, especially if you’re a cat owner. However, it can lead to severe complications for your baby if you contract it while you’re pregnant.

For your safety, we’ve compiled a guide outlining the causes, risks, and simple precautions you can take to ensure a healthy pregnancy.

Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. Unless you’re immunocompromised, you probably won’t get sick or develop any serious problems if you’re infected with the parasite.

However, it’s dangerous if you’re pregnant because the infection can pass to your baby through the placenta and affect her development. 1

How does toxoplasmosis spread?

Common sources of the parasite include: 2

• Undercooked or unwashed food: About 50% of all toxoplasmosis infections come from food, such as undercooked meat. Fruits and vegetables can also become contaminated through contact with soil containing the parasite, which is one reason why unwashed greens are some of the top ten foods to avoid during your pregnancy.
• Cat feces: Cats can become infected by eating infected prey and shed the parasite in their feces. Insects that come into contact with their poop can also get infected, such as flies, cockroaches, etc. 2
• Contaminated water: Though this is less common, drinking water contaminated with Toxoplasma gondii is another potential source of infection.

In rare cases, you may get the parasite if you receive an organ transplant or blood transfusion from an infected person. 3

Toxoplasmosis tends to be more common in regions with warm, humid climates. You’re more likely to get it if you work in meatpacking operations or a veterinary clinic or animal shelter. 4

Each year, between 800 and 4,400 babies in the US are born with toxoplasmosis. It’s estimated that more than 40 million people in the US may have the parasite. 6

Who is most at risk of toxoplasmosis?

Unfortunately, you might pass the infection on to your baby if you contract the parasite during pregnancy. This type of transferred infection is known as congenital toxoplasmosis. About one-third to one-half of babies born to infected moms-to-be end up being infected themselves. 7

Your baby may also contract the parasite if you were infected just before getting pregnant, usually within the past six months. 8

When does toxoplasmosis usually transfer in pregnancy?

Your baby’s less likely to develop toxoplasmosis in the first trimester, but the consequences are more severe if she does. Her risk of infection increases as the pregnancy progresses, from about 25% in the first trimester to 50%–65% in the third trimester. 1

Most babies with congenital toxoplasmosis don’t show any symptoms at birth, but may develop abnormally (e.g., developing an abnormally large or small head). 9

The infection can also cause a range of other developmental issues: 1 7 10

• Hearing loss
• Vision loss, crossed eyes, or uncontrollable eye movements
• Mental and learning disabilities
• Seizures
• Enlarged liver and spleen
• Pneumonia
• Infection, fever, and rash
• Miscarriage or stillbirth

To reiterate, even if your baby has no symptoms at birth, many of these issues can show up later in life if toxoplasmosis isn’t treated early on. For instance, your baby could be vulnerable to intellectual and developmental issues even 20 to 30 years later. 6

Most people infected with Toxoplasma gondii don’t experience any symptoms. If you develop any, they’ll probably be mild and flu-like, which makes it difficult to distinguish toxoplasmosis from other common illnesses.

You may experience: 2 9

• Sore throat and swollen lymph nodes
• Muscle aches
• Fatigue
• Fever
• Headache
• Rash

Rarer (but more obvious) symptoms can include confusion, blurred vision, trouble speaking (i.e., slurring your words), or being unsteady on your feet. 11

After you’re infected, it might take anywhere from 1 to 4 weeks (usually 7–14 days) for you to notice these symptoms, if they develop at all. 12

Since toxoplasmosis’s symptoms are often subtle or not present, it’s better to take preventive measures if you’re pregnant or planning to become pregnant.

The good news is that toxoplasmosis is largely preventable by taking a few simple precautions.

Here’s what you’ll need to be mindful of:

Food safety

Again, most cases of toxoplasmosis come from contaminated and undercooked food, especially lamb, pork, and venison, as well as shellfish like oysters, mussels, and clams, so take special precautions with your pregnancy diet. 3 11

If possible, freeze meat for a few days before cooking it. After that, cook it thoroughly while using a food thermometer to ensure the meat reaches a safe internal temperature.

Safe internal temperatures for food in pregnancy

Check out this table from the CDC to see safe internal temperatures for different animal products: 13

The US Department of Agriculture (USDA) also recommends leaving whole cuts of meat to rest for 3 minutes after cooking to ensure any pathogens are destroyed. 14 Remember to clean your thermometer, too.

Moreover, make sure that you wash your fruits and veggies under running water. Use hot soapy water when washing your utensils, cutting boards, countertops, dishes, or other areas that could come into contact with raw meat, poultry, seafood, or unwashed produce.

The same goes for your hands. Make sure you wash them thoroughly with soap and water before and after handling food.

Cat care

As mentioned, cats can carry the parasite and spread it in their poop. They shed millions of these parasites in their feces for as long as 3 weeks after they get infected. 3

Try not to handle cat litter while you’re pregnant. Instead, ask your partner (or a friend or relative) to change it every day. If you really have to do it yourself, wear disposable gloves and wash your hands thoroughly afterward.

Cats can contract toxoplasma after eating infected rodents, birds, or other small prey, so try to keep your furry friend indoors as much as possible. Even if you have a strictly indoor cat, stick to commercial cat food or well-cooked table scraps, and never give them raw or undercooked meat.

Moreover, keep your cat off your kitchen counters and dining tables, and always wash your hands after playing with them, especially before eating.

Other precautions

You can also reduce your risk of toxoplasmosis by:

• Being mindful when gardening: Dirt can also be contaminated, so wear gloves when you’re gardening and again, wash your hands thoroughly afterward.
• Avoiding hazardous outdoor areas: Avoid public sandboxes, which are sometimes contaminated with cat feces.
• Practicing good hygiene: Don’t touch your mouth, nose, or eyes while preparing food or gardening.
• Taking precautions while travelling: If you plan to go camping, always stick to bottled water. The same goes for trips to developing countries.

If you have other children, teach them about hygiene and make sure everyone in your household is on the same page.

Remembering all of these safety precautions can be overwhelming, so consider keeping track of them (and any questions you may have about further prevention) in your journal or pregnancy tracker app.

Doctors don’t always recommend routine screening for toxoplasmosis due to the low infection rate and potential unreliability of results. 15 16

However, if you suspect you may have been exposed to the parasite or are experiencing symptoms, talk to your doctor or midwife. They’ll order a blood test to check for Toxoplasma gondii antibodies.

If you’re diagnosed with toxoplasmosis, your doctor may recommend a procedure called amniocentesis to determine if your baby has also been infected. During this test, they will insert a long, thin needle into your womb through your belly so that they can take a sample of the amniotic fluid.

You’ll also have a few ultrasounds to monitor your baby’s development and look for any signs of abnormalities.

Treatment

If it turns out you contracted toxoplasmosis, your doctor might prescribe antibiotics to reduce the risk of transmission to your baby and minimize potential complications. The specific antibiotic used will depend on how far along you are in your pregnancy.

If your baby is born with toxoplasmosis, they will be treated with antibiotics for approximately one year, even if they don’t have any symptoms. They will also undergo special hearing and eye exams, as well as imaging of their brain.

Although toxoplasmosis can be a serious concern during pregnancy, there are many ways you can reduce the risk to you and your baby. Good hygiene, safe kitchen practices, and being a responsible pet owner will be enough to greatly reduce your risk.

Still, if you have any lingering concerns, reach out to your doctor for personalized advice and guidance.