McMichael Gai, MacLennan Alastair, Gibson Catherine, Alvino Emily, Goldwater Paul, Haan Eric, Dekker Gustaaf
Robinson Institute, The University of Adelaide, Women's and Children's Hospital, Adelaide, SA, Australia.
J Matern Fetal Neonatal Med. 2012 Oct;25(10):2078-81. doi: 10.3109/14767058.2012.666587. Epub 2012 Mar 23.
Intrauterine infection is a risk factor for cerebral palsy. Previous work reported a high frequency of viral DNA in newborn screening cards from cerebral palsy cases and controls possibly due to contamination.
Retrospective case-control study using improved methodologies to minimize contamination during PCR-based detection of viral DNA sequences. Newborn screening cards of 339 Caucasian children with cerebral palsy and 594 controls were examined. Viruses tested were herpes simplex viruses 1 and 2 (HSV1 and 2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes viruses 6, 7 and 8 (HHV6, HHV7 and HHV8), and parvovirus B19. Genotyping was performed on DNA extracted from dried blood spots.
CMV and EBV were detected in 5 (1.5%) and 3 (0.9%) of 339 cases, respectively, but not in controls (p = 0.047 and 0.006). Frequencies of detection of the other viruses examined were similar for cases and controls. DNA from at least one of the nine viruses tested was found in 4.4% of cases and 3.1% of controls [OR 1.4 95% CI (0.71-2.76)].
Evidence of congenital viral infection was uncommon in cases of cerebral palsy and controls. However, CMV and EBV were significantly associated with cerebral palsy.
宫内感染是脑瘫的一个风险因素。先前的研究报告称，脑瘫病例和对照的新生儿筛查卡片中病毒DNA频率较高，这可能是由于污染所致。
采用改进方法进行回顾性病例对照研究，以尽量减少基于PCR检测病毒DNA序列过程中的污染。对339名患脑瘫的白种儿童和594名对照的新生儿筛查卡片进行检测。检测的病毒包括单纯疱疹病毒1型和2型（HSV1和HSV2）、水痘带状疱疹病毒（VZV）、爱泼斯坦-巴尔病毒（EBV）、巨细胞病毒（CMV）、人类疱疹病毒6、7和8型（HHV6、HHV7和HHV8）以及细小病毒B19。对从干血斑中提取的DNA进行基因分型。
在339例病例中，分别有5例（1.5%）和3例（0.9%）检测到CMV和EBV，而对照中未检测到（p = 0.047和0.006）。病例组和对照组中其他检测病毒的检出频率相似。在4.4%的病例和3.1%的对照中发现了至少一种所检测的九种病毒的DNA [比值比1.4，95%可信区间（0.71 - 2.76）]。
先天性病毒感染的证据在脑瘫病例和对照中并不常见。然而，CMV和EBV与脑瘫显著相关。
