This sheet talks about exposure to toxoplasmosis in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is toxoplasmosis?
Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. You can get it by eating infected meat that hasn’t been cooked properly, drinking water that is contaminated, or handling soil or cat feces that contain the parasite. Most adults have no symptoms if infected. Some people might have swelling of the lymph nodes, fever, headache or muscle pain (flu-like symptoms). In most cases, once you have gotten toxoplasmosis, you cannot get it again.
How can I find out if I have a chance to get toxoplasmosis?
Around 65% to 85% of pregnant women in the United States have a chance of getting toxoplasmosis. Women who have recently gotten a cat or have outdoor cats, eat undercooked meat, garden, or who have had a recent mononucleosis-type illness have an increased chance.
A blood test can tell if you have ever had toxoplasmosis. When possible, testing for toxoplasmosis should be done before getting pregnant. If an infection is found during pregnancy, more than one test may be needed to see whether the infection is recent or old. Talk with your healthcare provider about your concerns and testing.
What can I do to avoid infection?
Toxoplasma gondii can be found in raw or undercooked meat, raw eggs and unpasteurized milk. Cats that eat raw meat or rodents can become infected. Once infected, the cat can shed the parasite in the feces for up to two weeks. Toxoplasma gondii eggs can live in cat feces or buried in soil up to 18 months. To avoid infection, pregnant women should:
- Cook meat until it is no longer pink and the juices run clear. A food thermometer should be used to measure the internal temperature to make sure the meat is cooked all the way through.
- Wash cutting boards, dishes, counters and utensils with hot soapy water after any contact with raw meat, seafood, or unwashed fruits or vegetables.
- Wash hands carefully after handling raw meat, fruit, vegetables, and soil.
- Wash all fruits and vegetables. Peeling fruits and vegetables also helps to reduce the chance of exposure.
- Do not touch cat feces directly; wear gloves if changing cat litter & immediately wash hands.
- Do not feed cats raw meat.
Does having toxoplasmosis in the past increase the chance of birth defects or other pregnancy complications?
Infection of the developing baby only occurs when the mother has an active infection during pregnancy. In general, there is no increased chance to the baby when toxoplasmosis occurs more than 6 months before conception. If you had toxoplasmosis in the past, you are likely immune, which means there is no increased chance to the baby. If you have a weakened immune system, you can develop another active infection.
Does having toxoplasmosis increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. An increased chance for miscarriage has been reported in women with active toxoplasmosis infection during pregnancy.
Does having toxoplasmosis in the first trimester increase the chance of birth defects?
In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. The toxoplasmosis parasite is known to cross the placenta. In about one in five (20%) cases of toxoplasmosis in pregnancy, the baby is also infected. Babies who become infected during pregnancy have “congenital toxoplasmosis” infection. In the United Sates, between 400 and 4000 babies are born with toxoplasmosis each year. Some infants with congenital toxoplasmosis will have problems with the brain, eyes, heart, kidneys, blood, liver, or spleen.
When the mother is infected during the first trimester, the baby is at a higher chance for severe problems from infection. However, the chance that the baby will be infected is about 10-15%.
Would having toxoplasmosis in the second or third trimester cause other pregnancy complications?
When the mother is infected late in pregnancy, the chance that the baby will have severe problems is very small. An increased chance for stillbirth has been reported in women with active toxoplasmosis infection during pregnancy.
Does having toxoplasmosis in pregnancy cause long-term problems for the baby?
Infants with congenital toxoplasmosis usually don’t appear any different at birth. Long-term studies show that up to 90% develop problems including vision loss, seizures, hearing loss, or developmental delays. These symptoms can occur months or years after birth. Infants with congenital toxoplasmosis should be treated for the infection during the first year of life and then should be checked every so often for problems.
How can I find out if my baby has been infected with toxoplasmosis?
If you have recently been infected, the fluid around the baby or fetal blood can be tested. If the baby is infected, these tests cannot tell you how serious the infection is. About one out of three babies with congenital toxoplasmosis will have a problem that can be seen on ultrasound. After birth, a blood test can be done on the baby to see if they are infected.
Is there any treatment for toxoplasmosis during pregnancy?
Finding the infection early and treating it as soon as possible can lower the chance that the baby will become infected. If the baby has already become infected, treatment with medications might make the baby’s disease less severe. Your healthcare provider can discuss specific treatment options with you.*
If I have or have had toxoplasmosis, should I avoid breastfeeding my baby?
Since most women with a history of toxoplasmosis will build immunity to the parasite, it is unlikely that toxoplasmosis will be passed through breast milk. The Center for Disease Control and Prevention (CDC) recommends women with active infection breastfeed unless they have broken skin or bleeding in the nipple area. Talk to your healthcare provider about all your breastfeeding questions.*
Should I be concerned if the father of my baby has toxoplasmosis while I am pregnant or breastfeeding?
At this time, there are no studies suggesting that a father can pass toxoplasmosis on to you or the baby. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
* Section Updated May 2020
References Available By Request.