Seo Soyeon, Cho YoungSook, Park Joonseok
Samkwang Medical Laboratories, Seoul, Korea.
Korean J Lab Med. 2009 Dec;29(6):557-62. doi: 10.3343/kjlm.2009.29.6.557.
Primary human cytomegalovirus (CMV) infection during pregnancy is a major cause of congenital malformation. We detected primary CMV infection in pregnant Korean women by using an algorithm that comprises CMV IgG, IgM, and IgG avidity tests.
During a 2-month period, 744 pregnant women who were at 10-19 weeks of gestation were consecutively enrolled in this study. Human anti-CMV IgG and IgM levels in their sera were determined by chemiluminescence immunoassays. Serum samples from the women who were positive for CMV IgG and IgM were assayed by the ARCHITECT CMV IgG avidity test in order to distinguish primary from non-primary CMV infection. Gross examination of the neonates of the women who were positive for CMV IgM was conducted.
The seroprevalence of CMV IgG and IgM was estimated to be 98.1% and 1.7%, respectively. The samples from all the women who were positive for CMV IgM or with grey zone results contained high avidity CMV IgG. Seven women with positive CMV IgG and IgM results who completed follow-up up to delivery showed no gross evidence of in utero CMV transmission.
Maternal primary CMV infection was not detected in any of the pregnant women included in this study cohort. CMV IgG avidity test enabled the identification of women who were at a low risk of transmitting CMV infection and provided informative for subsequent pregnancy outcomes. Compared to previous studies, the seroprevalence of CMV IgG antibody across pregnant Korean women remained unchanged.
孕期原发性人巨细胞病毒(CMV)感染是先天性畸形的主要原因。我们使用一种包含CMV IgG、IgM和IgG亲和力检测的算法,检测韩国孕妇中的原发性CMV感染。
在为期2个月的时间里,本研究连续纳入了744名妊娠10 - 19周的孕妇。通过化学发光免疫分析法测定她们血清中的人抗CMV IgG和IgM水平。对CMV IgG和IgM呈阳性的女性血清样本进行ARCHITECT CMV IgG亲和力检测,以区分原发性和非原发性CMV感染。对CMV IgM呈阳性的女性所分娩新生儿进行大体检查。
CMV IgG和IgM的血清阳性率分别估计为98.1%和1.7%。所有CMV IgM呈阳性或处于灰区结果的女性样本均含有高亲和力的CMV IgG。7名CMV IgG和IgM结果呈阳性且完成随访直至分娩的女性,未发现有宫内CMV传播的明显证据。
本研究队列中的任何孕妇均未检测到母体原发性CMV感染。CMV IgG亲和力检测能够识别出CMV感染传播风险较低的女性,并为后续妊娠结局提供信息。与先前研究相比,韩国孕妇中CMV IgG抗体的血清阳性率保持不变。