Collinet P, Subtil D, Houfflin-Debarge V, Kacet N, Dewilde A, Puech F
Clinique de Gynécologie, Hôpital Jeanne de Flandre, Obstétrique et Néonatalogie, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille Cedex, France.
Eur J Obstet Gynecol Reprod Biol. 2004 May 10;114(1):3-11. doi: 10.1016/j.ejogrb.2003.09.016.
Cytomegalovirus (CMV) screening during pregnancy has been widely discussed for several years, but still no consensus has been agreed. With a number of live births of 750,000 per year in France, we would expect 7500 infected infants at birth per year (rate of congenital infection of 1%). Among infected infants at birth, the number of severely infected foetuses would be approximately 75, the number of infants with severe sequelae would be 480, 675 approximately would present with hearing loss and the number of asymptomatic infants would be 6270. Five different preventive methods for congenital CMV infection are possible: (1) Routine CMV screening at the beginning of pregnancy for primary prevention. (2) Secondary prevention by antenatal diagnosis of congenital CMV infection complications. (3) Tertiary prevention by serological testing during pregnancy. (4) Tertiary prevention by serological screening at birth. (5) Tertiary prevention: Hearing loss screening at birth. The aims of this review are to define the advantages and disadvantages of these different methods of CMV screening during pregnancy and to determine if the current available information would make systematic testing acceptable.
多年来,孕期巨细胞病毒(CMV)筛查一直备受广泛讨论,但仍未达成共识。法国每年有75万例活产,我们预计每年有7500名婴儿出生时感染(先天性感染率为1%)。在出生时受感染的婴儿中,严重感染胎儿的数量约为75例,有严重后遗症的婴儿数量为480例,约675例将出现听力丧失,无症状婴儿数量为6270例。先天性CMV感染有五种不同的预防方法:(1)孕期开始时进行常规CMV筛查以进行一级预防。(2)通过对先天性CMV感染并发症进行产前诊断进行二级预防。(3)孕期进行血清学检测进行三级预防。(4)出生时进行血清学筛查进行三级预防。(5)三级预防:出生时进行听力丧失筛查。本综述的目的是确定孕期这些不同CMV筛查方法的优缺点,并确定当前可用信息是否会使系统检测变得可接受。