Adler Stuart P, Finney Jack W, Manganello Anne Marie, Best Al M
Department of Pediatrics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298-0163, USA.
J Pediatr. 2004 Oct;145(4):485-91. doi: 10.1016/j.jpeds.2004.05.041.
To determine if protective behavior prevents child-to-mother transmission of cytomegalovirus (CMV) during pregnancy.
We studied 166 seronegative mothers (94% white women; mean age, 33 years) with a child <36 months of age attending a day care facility. Mothers, either pregnant or attempting pregnancy, were randomly assigned by day care center to either a control or intervention group. Mothers in the intervention group received instructions for hand washing, glove use, and for avoiding types of intimate contact with their child. The control group received no instructions or information about their serologic status or whether their child was shedding CMV.
In the intervention group, 7.8% of women (9 of 115) seroconverted, as did 7.8% of women (4 of 51) in the control group. Two independent predictors of maternal infection were (1) a child shedding and (2) a mother attempting pregnancy at enrollment. For 41 women attempting pregnancy at enrollment with a child shedding CMV, 10 of 24 became infected compared with only 1 of 17 women who were already pregnant at enrollment ( P = .008).
For seronegative women who already know they are pregnant, intervention may be highly effective for preventing CMV acquisition.
确定孕期采取防护行为是否可预防巨细胞病毒(CMV)母婴传播。
我们研究了166名血清学阴性的母亲(94%为白人女性;平均年龄33岁),她们的孩子年龄小于36个月,且都在日托机构。母亲们,无论是已怀孕还是正在尝试怀孕,由日托中心随机分配到对照组或干预组。干预组的母亲们接受了关于洗手、戴手套以及避免与孩子进行某些亲密接触的指导。对照组未接受关于她们血清学状态或孩子是否排出CMV的指导或信息。
干预组中7.8%的女性(115名中的9名)发生血清转化,对照组中7.8%的女性(51名中的4名)也发生血清转化。母亲感染的两个独立预测因素为:(1)孩子排出病毒;(2)入组时母亲正在尝试怀孕。对于41名入组时正在尝试怀孕且孩子排出CMV的女性,24名中有10名被感染,而相比之下,入组时已怀孕的17名女性中只有1名被感染(P = 0.008)。
对于已知自己已怀孕的血清学阴性女性,干预措施可能对预防CMV感染非常有效。