Seroprevalence of anti-Toxoplasma antibodies among hospitalized newborns and their mothers: associated factors and maternal awareness in a cross-sectional study in Yasuj, Iran

BACKGROUND: Toxoplasma gondii is a major congenital parasitic pathogen that can be transmitted vertically and is associated with a wide spectrum of adverse fetal and neonatal outcomes. In Iran, data on concurrent maternal-neonatal serological assessments remain limited, particularly in hospital-based settings. Neonatal serology is often interpreted without parallel maternal data or contextual information on awareness and risk factors. This hospital-based cross-sectional study in Yasuj, southwestern Iran, aimed to determine the seroprevalence of anti-Toxoplasma IgG and IgM among hospitalized infants and their mothers and to investigate associated factors and maternal awareness. METHODS: This cross-sectional study was conducted on 224 mother-infant pairs who were admitted to the neonatal ward and NICU of Imam Sajjad Hospital, Yasuj, between March and October 2023. Demographic characteristics, behavioral factors, and maternal awareness were collected through a structured questionnaire. IgG and IgM antibodies were measured by ELISA as part of a seroepidemiological assessment of maternal-neonatal antibody profiles. The association between maternal IgG seropositivity and various variables was analyzed using chi-square tests and logistic regression. RESULTS: Among the mothers, 54 (24.1%) tested positive for IgG (95% CI: 19.0-30.1), while only one tested positive for IgM (0.4%; 95% CI: 0.1-2.5). Among the 224 infants, 9 (4%) were seropositive for IgG (95% CI: 2.1-7.5), all of whom were born to IgG-positive mothers; no infants tested positive for IgM, and no serological findings were suggestive of congenital infection. Cat exposure was the only factor independently associated with IgG seropositivity (aOR = 2.14; p = 0.020). Other variables, including age, education, place of residence, and consumption of undercooked meat, did not show significant associations. Maternal awareness was very low; only 13% had heard of the disease, and knowledge of transmission routes, prevention methods, and fetal outcomes was 4%, 2%, and 6%, respectively. CONCLUSIONS: Maternal seropositivity was detected, whereas no infant showed serological evidence suggestive of congenital transmission at the time of testing. Cat contact was the only behavioral factor independently associated with seropositivity. Maternal awareness was limited, particularly regarding transmission routes, prevention, and potential fetal risks. Strengthening prenatal education and incorporating risk-based assessment into routine care may support preventive strategies.