Eskild Anne, Jenum Pål A, Bruu Anne-Lise
Division of Epidemiology, Norwegian Institute of Public Health, Nydalen, Norway.
Acta Obstet Gynecol Scand. 2005 Nov;84(11):1035-41. doi: 10.1111/j.0001-6349.2005.00796.x.
The aim of this study was to assess the impact of maternal cytomegalovirus (CMV) antibody status in pregnancy on the risk of fetal death and of low birth weight.
The study of fetal death risk was a nested case-control study. Cases were all women within a cohort of 35,940 pregnant women in Norway 1992--94, who experienced fetal death after 16th week of gestation (n=281). Controls were 957 randomly selected women with live born children. Both groups were identified through linkage to the Norwegian Medical Birth Registry. The risk of low birth weight was studied in the live born children.
Seventy-two percent (203/281) of the cases and 69% (662/957) of the controls had CMV immunoglobulin G (IgG) antibodies in the first trimester (P=0.3). 0.4% (1/281) of the cases and 0.7% (7/957) had CMV IgM antibodies in the first trimester (P=0.7). Among 322 initially CMV antibody-negative women, 11% (6/55) of the cases and 9% (24/267) of the controls had occurrence of CMV IgG and/or IgM antibodies (P=0.7) during pregnancy. Also, after control for maternal age, parity, and follow-up time, no association between CMV antibodies and fetal death was found. CMV antibody status was not associated with low birth weight.
This study does not support a causal relation between CMV infection in pregnancy and fetal death or low birth weight.
本研究旨在评估孕期母亲巨细胞病毒(CMV)抗体状态对胎儿死亡风险和低出生体重风险的影响。
胎儿死亡风险研究为一项巢式病例对照研究。病例为1992 - 1994年挪威35940名孕妇队列中所有在妊娠16周后发生胎儿死亡的妇女(n = 281)。对照为957名随机选取的有活产儿的妇女。两组均通过与挪威医学出生登记处的关联确定。对活产儿的低出生体重风险进行了研究。
72%(203/281)的病例和69%(662/957)的对照在孕早期有CMV免疫球蛋白G(IgG)抗体(P = 0.3)。0.4%(1/281)的病例和0.7%(7/957)在孕早期有CMV IgM抗体(P = 0.7)。在322名最初CMV抗体阴性的妇女中,11%(6/55)的病例和9%(24/267)的对照在孕期出现了CMV IgG和/或IgM抗体(P = 0.7)。此外,在对母亲年龄、产次和随访时间进行校正后,未发现CMV抗体与胎儿死亡之间存在关联。CMV抗体状态与低出生体重无关。
本研究不支持孕期CMV感染与胎儿死亡或低出生体重之间存在因果关系。