Abstract
BACKGROUND: Preeclampsia (PE) is a major global health concern, contributing to adverse maternal and perinatal outcomes. While its exact pathogenesis remains unclear, abnormal placentation, immune dysregulation, and systemic inflammation are implicated. Emerging evidence suggests that chronic infections, including toxoplasmosis may increase PE risk. This study investigates the seroprevalence of Toxoplasma gondii (T. gondii) infection in pregnant women with and without PE and analyses associated risk factors. METHODS: This comparative study examined 180 participants (90 preeclamptic cases and 90 healthy controls) from prenatal care centers in Mazandaran, northern Iran. ELISA testing measured T. gondii IgG and IgM antibodies levels in collected serum specimens.Thepotential risk factors through validated surveys capturing demographic characteristics, nutritional patterns, educational background, and toxoplasmosis knowledge were assessed. The investigation employed a matched case-control design to evaluate associations between seropositivity and clinical outcomes. RESULTS: The seroprevalence of anti-T. gondii IgG was significantly higher in the PE group (71.11%) compared to controls (56.66%) (P = 0.045), while no IgM-positive cases were detected, suggesting chronic infection. Logistic regression analysis identified age > 30 years, consumption of undercooked meat, lower educational attainment, and lack of awareness regarding toxoplasmosis as independent risk factors for toxoplasmosis-associated PE. CONCLUSION: The findings reveal that chronic toxoplasmosis is associated with an increased risk of PE, particularly among older housewives and women with limited health literacy. Public health interventions, including education on safe food handling practices and prenatal screening, have the potential to reduce both infection rates and the incidence of PE.