Toxoplasmosis in pregnancy: cats, raw meat and soil, the HFMD risk from young children, and how to protect your baby in Singapore

Toxoplasmosis in pregnancy is an infection with a parasite that can pass to your baby. SingHealth says it can cause premature delivery and serious malformations, and that it usually spreads from contact with cat faeces. Mayo Clinic adds undercooked meat and unwashed fruit and vegetables as common routes, and notes that most infected adults have no symptoms at all. You don't need to give up your cat. Let someone else change the litter, wear gloves for gardening, wash produce, and eat meat cooked through. Young children bring a second risk in Singapore: hand, foot and mouth disease (HFMD), which KKH says can cause miscarriage or stillbirth in pregnancy and severe illness in a newborn if you catch it near delivery.

How toxoplasmosis spreads

Mayo Clinic suggests keeping your cat indoors on dry or canned food rather than raw meat, avoiding stray cats and kittens, and not adopting a new cat while you're pregnant.

What it can do to your baby

Most adults never notice they've been infected. Some get a mild, flu-like illness with fever, swollen glands, headache, aches and sometimes a rash, Mayo Clinic says. The concern is the baby. SingHealth warns that toxoplasmosis in pregnancy can cause premature delivery and serious malformations, and Mayo Clinic says infection in the first trimester tends to be more severe and may lead to miscarriage. Mayo Clinic says most infected babies show no symptoms at birth, but problems with the eyes, hearing or development can appear later in childhood.

If you think you've been exposed, or you have a flu-like illness with swollen glands, tell your gynae. They can decide whether you need a blood test, and Mayo Clinic says pregnant women with toxoplasmosis are among the people who are treated with medicine.

How to protect yourself

The same habits protect you from other infections in pregnancy. KKH's dietitian advises against sashimi, eggs benedict and medium-rare steak, because raw or undercooked meat, eggs and seafood can carry salmonella, E. coli and listeria, and says food should be served hot. Our guide to foods to avoid during pregnancy has safe hawker swaps, and food poisoning while pregnant explains what to do if you think you've eaten something risky.

HFMD in pregnancy: the risk from young children

Hand, foot and mouth disease is caused by enteroviruses, most often coxsackievirus and enterovirus, and KKH says it's very common in Singapore, especially among preschoolers. That matters if you have a toddler in childcare. KKH says pregnant women who catch HFMD may have a miscarriage or stillbirth, and if the infection is close to delivery, the newborn can become severely ill with multiorgan failure.

Our guide to HFMD in Singapore covers the preschool return rules and which disinfectants work. A partner or grandparent can take over the sick child's care in the final weeks of pregnancy if you're able to arrange it.

Frequently asked questions

Can I keep my cat while I'm pregnant?

Yes. SingHealth's advice is about the litter tray, not the cat: wash your hands after changing it, or better, ask someone else to. Keep your cat indoors and don't get a new kitten while pregnant. Our guide to cleaning products while pregnant covers the other household jobs to hand over.

What are the symptoms of toxoplasmosis in pregnancy?

Usually none. Mayo Clinic says some people get flu-like symptoms such as fever, swollen glands, headache and muscle aches. Tell your gynae if you have these and think you've been exposed.

How does toxoplasmosis affect the baby?

SingHealth says it can cause premature delivery and serious malformations. Mayo Clinic says infection in the first trimester tends to be more severe and may cause miscarriage.

Can I eat steak while pregnant?

Only well done, with no pink inside. KKH's dietitian advises against medium-rare steak and other raw or undercooked meat in pregnancy.

Is HFMD dangerous in pregnancy?

It can be. KKH says HFMD in pregnancy may lead to miscarriage or stillbirth, and to severe illness in the newborn if caught close to delivery. Wash your hands often if your child is unwell, and tell your gynae.