芬兰西南部水痘带状疱疹病毒、巨细胞病毒、单纯疱疹病毒和细小病毒B19感染的血清流行率、产前感染发生率及母亲病史的可靠性
Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in South-Western Finland.
作者信息
Alanen Anna, Kahala Kaisa, Vahlberg Tero, Koskela Pentti, Vainionpää Raija
机构信息
Department of Obstetrics and Gynaecology, University of Turku, Finland.
出版信息
BJOG. 2005 Jan;112(1):50-6. doi: 10.1111/j.1471-0528.2004.00320.x.
OBJECTIVE
To study seroprevalence and incidence and fetal transmission of varicella zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV) types 1 and 2 and parvovirus B19 infections during pregnancy and to evaluate the reliability of maternal past history of VZV, HSV and parvovirus infections.
DESIGN
Prospective study of parturient women.
SETTING
South-Western Finland.
PARTICIPANTS
Five hundred and fifty-eight parturient women.
METHODS
IgG and IgM antibodies against VZV, CMV, HSV-1 and -2, and parvovirus B19 were measured from maternal serum in the first trimester and at delivery and from cord serum, mother's own information of her past infections was compared with her serological status.
MAIN OUTCOME MEASURES
Seroprevalence, seroconversions and fetal transmission of VZV, CMV, HSV and parvovirus B19, reliability of maternal history of VZV, HSV and parvovirus B19.
RESULTS
Seroprevalences were 96.2% for VZV, 56.3% for CMV, 54.3% for HSV, 46.8% for HSV-1, 9.3% for HSV-2 and 58.6% for parvovirus B19. Parity was associated with CMV seropositivity, maternal age differed only between HSV-2 seropositive and seronegative women, while area of residence (urban or rural) had no effect. Six seroconversions were observed: two VZV, one CMV and three parvovirus infections. No cases of primary HSV infections occurred. Fetal transmission was observed in two cases of parvovirus infection. No infants with anti-CMV IgM antibodies were born to CMV immunised women. False positive history of chickenpox was given only by 1.5% of the women, history of herpes infections was less reliable, and history of parvovirus infection was unreliable.
CONCLUSIONS
Seroprevalence and the risk of viral infections during pregnancy cannot be extrapolated from one pregnant population to another.
目的
研究孕期水痘带状疱疹病毒(VZV)、巨细胞病毒(CMV)、1型和2型单纯疱疹病毒(HSV)以及细小病毒B19感染的血清流行率、发病率和胎儿传播情况,并评估孕妇既往VZV、HSV和细小病毒感染史的可靠性。
设计
对产妇进行前瞻性研究。
地点
芬兰西南部。
参与者
558名产妇。
方法
在孕早期和分娩时检测母血血清以及脐血血清中抗VZV、CMV、HSV-1和-2以及细小病毒B19的IgG和IgM抗体,将母亲自身关于既往感染的信息与其血清学状态进行比较。
主要观察指标
VZV、CMV、HSV和细小病毒B19的血清流行率、血清转换和胎儿传播情况,孕妇VZV、HSV和细小病毒B19感染史的可靠性。
结果
VZV的血清流行率为96.2%,CMV为56.3%,HSV为54.3%,HSV-1为46.8%,HSV-2为9.3%,细小病毒B19为58.6%。产次与CMV血清阳性相关,产妇年龄仅在HSV-2血清阳性和血清阴性女性之间存在差异,而居住地区(城市或农村)无影响。观察到6次血清转换:2次VZV感染、1次CMV感染和3次细小病毒感染。未发生原发性HSV感染病例。在2例细小病毒感染病例中观察到胎儿传播。CMV免疫的女性所生婴儿均无抗CMV IgM抗体。仅1.5%的女性给出了水痘的假阳性病史,疱疹感染史的可靠性较低,细小病毒感染史不可靠。
结论
孕期病毒感染的血清流行率和风险不能从一个孕妇群体推断到另一个孕妇群体。