Maternal-Infant Department, University and San Salvatore Hospital of L'Aquila, Italy.
J Infect Dis. 2012 Jan 15;205(2):215-27. doi: 10.1093/infdis/jir718. Epub 2011 Dec 2.
Primary cytomegalovirus (CMV) infection early in gestation causes severe disease.
Case patients were 32 congenitally infected children aged 1-5 years who had either hearing deficit and/or psychomotor retardation and whose mothers had a confirmed or probable primary CMV infection at ≤ 20 weeks' gestation. Control subjects were 32 congenitally infected normal children whose mothers had a confirmed primary infection at ≤ 20 weeks' gestation. Case patients and control subjects were matched by the weeks of maternal gestation (± 1 week) at the mother's infection and by the child's age (± 1 year) at evaluation.
For the case patients and control subjects, the mean age was 3.0 years. The mean number of weeks of gestation at maternal infection was 11 weeks. The only risk factor for an affected child was the mother not receiving immunoglobulin (P = .001). Of the 32 case patients, only 4 mothers received CMV immunoglobulin, compared with 27 of the 32 mothers of control infants (adjusted odds ratio, 14 [95% confidence interval, 1.7-110]). The rate of both psychomotor retardation and hearing deficit decreased with immunoglobulin.
These results support the efficacy of immunoglobulins for decreasing the severity of disabilities caused by fetal CMV infection after a primary maternal infection during pregnancy.
妊娠早期原发性巨细胞病毒（CMV）感染可导致严重疾病。
病例组为 32 名 1-5 岁患有听力缺陷和/或精神运动发育迟缓且其母亲在妊娠≤20 周时确诊或疑似原发性 CMV 感染的先天性感染儿童。对照组为 32 名母亲在妊娠≤20 周时确诊原发性感染的先天性感染正常儿童。通过母亲感染时的妊娠周数（±1 周）和儿童评估时的年龄（±1 岁）对病例组和对照组进行匹配。
对于病例组和对照组，平均年龄为 3.0 岁。母亲感染时的平均妊娠周数为 11 周。唯一的危险因素是母亲未接受免疫球蛋白治疗（P=0.001）。在 32 名病例组儿童中，仅有 4 名母亲接受了 CMV 免疫球蛋白治疗，而对照组婴儿的 32 名母亲中有 27 名接受了治疗（调整后的优势比，14[95%置信区间，1.7-110]）。免疫球蛋白治疗可降低精神运动发育迟缓及听力缺陷的发生率。
这些结果支持免疫球蛋白治疗可降低母体妊娠期间原发性感染后胎儿 CMV 感染引起的残疾严重程度。
