Early Warning Signs, Effects, Risk Factors, and Diagnostic Indicators of Toxoplasmosis in Pregnant Women: A Systematic Review

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Abstract
Toxoplasma gondii causes toxoplasmosis, a zoonosis of global importance, seriously affecting foetuses congenitally infected by their mother. Although early detection is important to prevent adverse fetal outcomes, maternal infections are frequently asymptomatic or present with mild, nonspecific signs. The present systematic review sought to synthesize evidence on early signs, risk factors, and diagnosis of toxoplasmosis in pregnant women. The study was conducted following the PRISMA 2020 guidelines. A literature search was conducted across PubMed, Scopus, ResearchGate, and Google Scholar for studies published between 2000 and 2025. The articles were exported to Zotero, citation management software. Duplicate articles were merged; those not published in English and lacking reference materials were excluded. After secondary screenings, 31 out of 407 articles met the inclusion criteria. Major maternal signs were lymphadenopathy (19.4%) and flu-like symptoms (19.4%), while major foetal effects were congenital anomalies (25.8%) and miscarriage (22.6%). Associated risk factors were contact with cat faeces and contaminated soil, consumption of undercooked or raw meat, raw vegetables, and contaminated water. Diagnosis was mainly by ELISA (65.5%). Therefore, routine screening awareness campaigns and timely diagnosis are recommended to safeguard maternal and fetal health in high-risk regions with limited diagnostic resources.

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