Zhang Jian-Ping, Li Fen, Yu Xue-Wen, Sheng Qiu, Shi Xiao-Wei, Zhang Xin-Wen
Maternal and Child Health Center, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, PR China.
Gynecol Obstet Invest. 2008;65(2):128-32. doi: 10.1159/000110013. Epub 2007 Oct 22.
Qinba Mountain area of Shanxi Province, China, is one of the poorest, culturally backward regions in China with a high incidence of mental retardation. To investigate whether cytomegalovirus (CMV) plays a role in the high incidence of mental retardation in this region, we studied the incidence of CMV infection during pregnancy and possible risk factors associated with CMV infection.
386 consecutive pregnant women in Qinba Mountain area were monitored for the level of a CMV-specific IgM antibody. Polymerase chain reaction was used to detect CMV in breast milk obtained within 2 weeks postpartum and urine samples of newborn infants born to actively CMV-infected mothers. Serum levels of TNF-alpha, IL-6, zinc, copper, iron and selenium were analyzed in CMV-infected pregnant women.
The incidence of CMV-active infection during pregnancy, intrauterine transmission and excretion in breast milk were 15.03, 33.33, and 39.58%, respectively. Active CMV infection during pregnancy was correlated with maternal age, education and economic status, parity, and history of obstetric complications. Those women who had active CMV infection, intrauterine transmission, or CMV excretion in milk showed higher values of TNF-alpha and IL-6, lower values of zinc as compared with health age-matched controls (p < 0.05). No differences were identified between studied cases and controls in the level of copper, iron, and selenium (p > 0.05).
The incidence of CMV-active infection during pregnancy was high in Qinba Mountain area of Shanxi Province. Zinc deficiency may be a risk factor for the development of CMV infection. TNF-alpha and IL-6 may be involved in the pathophysiologic process.
中国陕西省的秦巴山区是中国最贫困、文化落后的地区之一,智力发育迟缓发病率很高。为了调查巨细胞病毒(CMV)是否在该地区智力发育迟缓的高发病率中起作用,我们研究了孕期CMV感染的发生率以及与CMV感染相关的可能危险因素。
对秦巴山区386名连续孕妇监测CMV特异性IgM抗体水平。采用聚合酶链反应检测产后2周内采集的母乳以及CMV感染阳性母亲所生新生儿尿液样本中的CMV。分析CMV感染孕妇的血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、锌、铜、铁和硒水平。
孕期CMV活动性感染、宫内传播及母乳排泄的发生率分别为15.03%、33.33%和39.58%。孕期CMV活动性感染与产妇年龄、教育程度、经济状况、产次及产科并发症史相关。与年龄匹配的健康对照组相比,那些有CMV活动性感染、宫内传播或乳汁中CMV排泄的女性TNF-α和IL-6值较高,锌值较低(p<0.05)。研究病例与对照组在铜、铁和硒水平上未发现差异(p>0.05)。
陕西省秦巴山区孕期CMV活动性感染的发生率较高。锌缺乏可能是CMV感染发生的一个危险因素。TNF-α和IL-6可能参与了病理生理过程。