Al-Hareth Zakyieh, Monem Fawza, Abdel Megiud Nagwa
Clinical Laboratories Department, Al-Assad Hospital, Damascus University, Damascus, Syria.
J Infect Dev Ctries. 2009 Nov 5;4(1):44-7. doi: 10.3855/jidc.539.
Congenital cytomegalovirus infection is currently the leading cause of congenital infection in 0.2-2.2% of live births worldwide leading to variable serious sequalae. The aim of the study was to determine if low birth weight is an indicator of CMV congenital infection evidenced by detecting CMV-DNA in umbilical cord blood at the time of delivery.
CMV-IgG and IgM antibodies and CMV-DNAemia were assessed in umbilical cord blood of two hundreds newborns, one hundred of whom had birth weight < or = 2700 gram and/or head circumference < or = 32 cm.
CMV-IgM was not detected, while CMV-IgG was positive in 80-90% of the two hundreds tested newborns. CMV-DNA was detected in four out of the 200 newborns. One of them was over the adopted weight limit (> 2700 gram).
CMV-IgM and IgG antibodies assessment was not a potential discriminative test to identify congenitally infected newborns. In addition, low birth weight and small head circumference at birth failed to predict congenital CMV infection. CMV-DNA detection in umbilical cord blood at the time of delivery using real-time PCR of all newborns is recommended as decisive, rapid and non-invasive test.
先天性巨细胞病毒感染是目前全球0.2%-2.2%活产儿先天性感染的主要原因,会导致各种严重后遗症。本研究的目的是通过在分娩时检测脐带血中的巨细胞病毒DNA,确定低出生体重是否是巨细胞病毒先天性感染的一个指标。
对200名新生儿的脐带血进行巨细胞病毒IgG和IgM抗体以及巨细胞病毒血症评估,其中100名新生儿出生体重≤2700克和/或头围≤32厘米。
未检测到巨细胞病毒IgM,而在200名接受检测的新生儿中,80%-90%的巨细胞病毒IgG呈阳性。200名新生儿中有4名检测到巨细胞病毒DNA。其中1名超过了设定的体重限制(>2700克)。
巨细胞病毒IgM和IgG抗体评估并非识别先天性感染新生儿的潜在鉴别性检测方法。此外,出生时低体重和小头围无法预测先天性巨细胞病毒感染。建议对所有新生儿在分娩时使用实时PCR检测脐带血中的巨细胞病毒DNA,作为决定性、快速且无创的检测方法。