在高巨细胞病毒免疫的母体人群中，人巨细胞病毒再感染与宫内传播有关。
Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population.
机构信息
Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
出版信息
Am J Obstet Gynecol. 2010 Mar;202(3):297.e1-8. doi: 10.1016/j.ajog.2009.11.018. Epub 2010 Jan 13.
OBJECTIVE
To determine contribution of reinfection with new strains of cytomegalovirus in cytomegalovirus seromimmune women to incidence of congenital cytomegalovirus infection.
STUDY DESIGN
In 7848 women studied prospectively for congenital cytomegalovirus infection from a population with near universal cytomegalovirus seroimmunity, sera from 40 mothers of congenitally infected infants and 109 mothers of uninfected newborns were analyzed for strain-specific anticytomegalovirus antibodies.
RESULTS
All women were cytomegalovirus seroimmune at first prenatal visit. Reactivity for 2 cytomegalovirus strains was found in 14 of 40 study mothers and in 17 of 109 control mothers at first prenatal visit (P = .009). Seven of 40 (17.5%) study women and 5 of 109 (4.6%) controls (P = .002) acquired antibodies reactive with new cytomegalovirus strains during pregnancy. Evidence of infection with more than 1 strain of cytomegalovirus before or during current pregnancy occurred in 21 of 40 study mothers and 22 of 109 controls (P < .0001).
CONCLUSION
Maternal reinfection by new strains of cytomegalovirus is a major source of congenital infection in this population.
目的
确定巨细胞病毒血清免疫女性中新型巨细胞病毒再感染对先天性巨细胞病毒感染发生率的影响。
研究设计
在对人群进行了前瞻性研究，共有 7848 名巨细胞病毒血清免疫女性，这些女性可能存在先天性巨细胞病毒感染。对 40 名先天性感染婴儿的母亲和 109 名未感染新生儿的母亲的血清进行了分析，以确定其针对巨细胞病毒株的特异性抗体。
结果
所有女性在首次产前检查时均对巨细胞病毒具有血清免疫力。在首次产前检查时，14 名研究组母亲和 17 名对照组母亲的血清对 2 种巨细胞病毒株呈反应性（P=0.009）。7 名研究组女性（17.5%）和 5 名对照组女性（4.6%）在妊娠期间获得了与新的巨细胞病毒株反应的抗体（P=0.002）。在 21 名研究组母亲和 22 名对照组母亲中，在当前妊娠之前或期间发生了超过 1 种巨细胞病毒株感染的证据（P<0.0001）。
结论
在该人群中，新型巨细胞病毒的母体再感染是先天性感染的主要来源。
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