Yamamoto A Y, Mussi-Pinhata M M, Cristina P, Pinto G, Moraes Figueiredo L T, Jorge S M
Department of Puericulture and Pediatrics, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Pediatr Infect Dis J. 2001 Feb;20(2):188-92. doi: 10.1097/00006454-200102000-00014.
Cytomegalovirus (CMV) is the most frequent cause of congenital infections in humans. Prematurity occurs in as many as 34% of infants with symptomatic congenital CMV infection.
To determine the clinical presentation and frequency of congenital CMV infection among preterm infants and full-term infants from a population with a high seroprevalence rate.
DESIGN/METHODS: A total of 289 preterm infants (median gestational age, 34 weeks; median birth weight, 1,757 g) and 163 term infants (median gestational age, 39 weeks; median birth weight, 3,150 g) sequentially born were included in the study. Serum IgG antibodies to CMV were measured in all mothers. One urine sample was collected within the first 7 days of age from all newborns. Virus isolation in urine samples was performed by tissue culture, and viral DNA was detected by a multiplex PCR. CMV infection was diagnosed in infants with virus excretion detected by both methods on at least two occasions within the first 3 weeks of life.
Maternal CMV seropositivity rate was 95.7%. Congenital CMV infection was detected in 6 of 289 (2.1%) (95% confidence interval, 0.84 to 4.68) preterm infants and in 3 of 163 term infants (1.8%) (95% confidence interval, 0.48 to 5.74) (P > 0.05). Four of 6 preterm infants with congenital CMV infection were symptomatic, but none of the term infants was symptomatic (P = 0.16).
The frequency of congenital CMV infection in preterm newborn infants from mothers with a high seropositive rate was similar to that found in term infants. No significant difference was found between the proportion of symptomatic infants among preterm and term infants. Our finding of symptomatic congenital CMV infection underscores the need of further evaluation of correlates of congenital symptomatic infection in highly immune populations.
巨细胞病毒（CMV）是人类先天性感染最常见的病因。有症状的先天性CMV感染婴儿中早产发生率高达34%。
确定来自血清阳性率高的人群中的早产儿和足月儿先天性CMV感染的临床表现及发生率。
设计/方法：本研究纳入了依次出生的289例早产儿（中位胎龄34周；中位出生体重1757g）和163例足月儿（中位胎龄39周；中位出生体重3150g）。检测所有母亲血清中CMV的IgG抗体。在所有新生儿出生后7天内采集一次尿样。尿样通过组织培养进行病毒分离，并用多重聚合酶链反应检测病毒DNA。在出生后3周内，至少两次通过两种方法检测到病毒排泄的婴儿被诊断为CMV感染。
母亲CMV血清阳性率为95.7%。289例早产儿中有6例（2.1%）（95%置信区间为0.84至4.68）检测到先天性CMV感染，163例足月儿中有3例（1.8%）（95%置信区间为0.48至5.74）检测到先天性CMV感染（P>0.05）。6例先天性CMV感染的早产儿中有4例有症状，但足月儿均无症状（P=0.16）。
血清阳性率高的母亲所生早产儿先天性CMV感染的发生率与足月儿相似。早产儿和足月儿中有症状婴儿的比例无显著差异。我们发现有症状的先天性CMV感染强调了在高免疫人群中进一步评估先天性有症状感染相关因素的必要性。
