Tan Peng Chiong, Rajasingam Geetha, Devi Shamala, Omar Siti Zawiah
Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Obstet Gynecol. 2008 May;111(5):1111-7. doi: 10.1097/AOG.0b013e31816a49fc.
To estimate prevalence rate of recent dengue infection in parturients, as well as the vertical transmission rate, and to compare pregnancy outcomes among infected women.
A prospective cohort study was performed. Maternal and paired umbilical cord bloods were taken at delivery. A brief questionnaire on febrile illness and dengue in pregnancy was completed by participants. The samples were sent to a World Health Organization Collaborating Center for Arbovirus Reference and Research. Maternal sera were tested with a dengue-specific immunoglobulin M (IgM) capture test. The paired umbilical cord serum was tested to determine when the maternal sample was positive. Dengue reverse transcriptase polymerase chain reaction (PCR) was performed on all dengue IgM-positive sera. Pregnancy outcome was extracted from delivery records.
A total of 2,958 parturients were enrolled, and 2,531 paired maternal-umbilical cord blood samples were available for testing. Dengue-specific IgM was positive in 63 of 2,531 (2.5%, 95% confidence interval [CI] 1.9-3.2%) maternal samples. Only 1 of 64 (1.6%, 95% CI 0.0-9.5%) of the paired umbilical cord sera was IgM-positive. All reverse transcriptase PCR tests were negative. Fifty-six of 63 (88.9%) of dengue IgM-positive women did not report a febrile illness in pregnancy. Apart from a higher mean age in dengue IgM-positive women of 30.6+/-5.2 compared with 29.2+/-4.9 years (P=.025) compared with dengue IgM-negative women, all other characteristics were similar. Rates of preterm birth, mode of delivery, postpartum hemorrhage, low birth weight, and neonatal outcomes were not different.
Recent dengue infection was demonstrated in 2.5% of parturients, with a vertical transmission rate of 1.6%. Pregnancy outcome of recently infected women was not different.
II.
评估产妇近期登革热感染的患病率以及垂直传播率，并比较感染女性的妊娠结局。
进行了一项前瞻性队列研究。在分娩时采集产妇及其配对的脐带血。参与者完成了一份关于孕期发热疾病和登革热的简短问卷。样本被送往世界卫生组织虫媒病毒参考和研究合作中心。用登革热特异性免疫球蛋白M（IgM）捕获试验检测产妇血清。检测配对的脐带血清以确定产妇样本何时呈阳性。对所有登革热IgM阳性血清进行登革热逆转录聚合酶链反应（PCR）。从分娩记录中提取妊娠结局。
共纳入2958名产妇，2531对产妇-脐带血样本可供检测。2531份产妇样本中，63份（2.5%，95%置信区间[CI]1.9 - 3.2%）登革热特异性IgM呈阳性。64份配对脐带血清中只有1份（1.6%，95%CI 0.0 - 9.5%）IgM呈阳性。所有逆转录PCR检测均为阴性。63名登革热IgM阳性女性中有56名（88.9%）在孕期未报告发热疾病。与登革热IgM阴性女性相比，登革热IgM阳性女性的平均年龄较高，为30.6±5.2岁，而登革热IgM阴性女性为29.2±4.9岁（P = 0.025），其他所有特征相似。早产率、分娩方式、产后出血、低出生体重和新生儿结局无差异。
2.5%的产妇有近期登革热感染，垂直传播率为1.6%。近期感染女性的妊娠结局无差异。
II级。
