Fowler Karen B, Pass Robert F
Department of Pediatrics, University of Alabama, Birmingham, Alabama, USA.
Pediatrics. 2006 Aug;118(2):e286-92. doi: 10.1542/peds.2005-1142. Epub 2006 Jul 17.
Two recognized sources of maternal cytomegalovirus infection are young children and sexual activity. Previous studies evaluated either maternal exposures to young children or sexual activity, but these studies did not evaluate whether both of these maternal cytomegalovirus sources contribute to increases in congenital cytomegalovirus infections within populations with a high prevalence of infection among women of childbearing age. Our objective with this study was to investigate whether maternal cytomegalovirus exposure through young children and by sexual activity increases the risk for congenital cytomegalovirus infection in their offspring.
A case-control study of 519 women from a delivery population in Birmingham, AL, between December 1992 and July 1998 was undertaken to measure the association between maternal cytomegalovirus exposures and an increased risk for congenital cytomegalovirus infection in their infants. Routine newborn cytomegalovirus screening at the hospital identified infants with congenital cytomegalovirus infection. The cases (n = 150) were women who delivered an infant with congenital cytomegalovirus infection, and the control subjects (n = 369) were randomly selected from the delivery population of women whose newborns were uninfected. Investigation of exposures included using a standardized maternal interview, prenatal and medical chart abstraction, and laboratory confirmation of cytomegalovirus infection.
Significant associations between congenital cytomegalovirus infection and caring for preschool children in the year before delivery, onset of sexual activity < 2 years before delivery, sexually transmitted diseases during pregnancy, household size > 3 people, and maternal age < 25 years were identified. Women who cared for preschool children in the year before delivery and also became sexually active within the 2 years before delivery were at greatest risk for delivering an infant with congenital cytomegalovirus infection.
Caring for young children and recent onset of sexual activity contribute to an increased risk for congenital cytomegalovirus infection in the offspring of young women.
已知孕妇巨细胞病毒感染的两个来源是幼儿和性行为。以往的研究要么评估孕妇与幼儿的接触情况，要么评估性行为，但这些研究并未评估在育龄妇女感染率较高的人群中，这两种孕妇巨细胞病毒感染来源是否都会导致先天性巨细胞病毒感染增加。我们这项研究的目的是调查孕妇通过接触幼儿和性行为感染巨细胞病毒是否会增加其后代先天性巨细胞病毒感染的风险。
对1992年12月至1998年7月期间阿拉巴马州伯明翰市分娩人群中的519名妇女进行了一项病例对照研究，以测量孕妇巨细胞病毒感染与婴儿先天性巨细胞病毒感染风险增加之间的关联。医院对新生儿进行的常规巨细胞病毒筛查确定了患有先天性巨细胞病毒感染的婴儿。病例组（n = 150）为分娩出患有先天性巨细胞病毒感染婴儿的妇女，对照组（n = 369）是从新生儿未感染的分娩人群中随机选取的。对感染情况的调查包括使用标准化的孕妇访谈、产前和病历摘要，以及巨细胞病毒感染的实验室确认。
确定了先天性巨细胞病毒感染与分娩前一年照顾学龄前儿童、分娩前不到2年开始性行为、孕期性传播疾病、家庭人口数> 3人以及孕妇年龄< 25岁之间存在显著关联。在分娩前一年照顾学龄前儿童且在分娩前2年内开始性行为的妇女，分娩出患有先天性巨细胞病毒感染婴儿的风险最高。
照顾幼儿和近期开始性行为会增加年轻女性后代先天性巨细胞病毒感染的风险。
