Department of Obstetrics and Gynecology, Women and Infants Hospital/Brown University, Providence, RI 02905, USA.
Am J Perinatol. 2013 Feb;30(2):121-4. doi: 10.1055/s-0032-1333133. Epub 2013 Jan 4.
Congenital cytomegalovirus (CMV) is a leading cause of neonatal morbidity, affecting ~0.5 to 1% of infants born each year. Primary maternal infection during early pregnancy is the greatest risk factor for severe neonatal morbidity/mortality. The current recommendation from national organizations advises against routine screening of pregnant women for primary infection. Recent advancements in diagnosis and treatment raise the issue of implementation of a national screening program. Prior to development of a major screening program for a highly prevalent and costly disease, the screening test must be safe, reliable, and valid with an effective and feasible intervention. This article reviews recent literature regarding available screening tests and potential interventions and whether criteria for a screening program are met in the current state of science. Although screening women using CMV immunoglobulin (Ig) G, IgM, and IgG avidity testing is reliable, effective intervention with hygiene modification or treatment with CMV-specific hyperimmune globulin is not as well established. More evidence from randomized controlled trials is needed prior to moving forward with a screening program for congenital CMV.
先天性巨细胞病毒（CMV）是导致新生儿发病的主要原因，每年约有 0.5%至 1%的婴儿受到影响。孕妇在妊娠早期初次感染是导致新生儿严重发病/死亡的最大危险因素。目前，国家组织的建议是不常规筛查孕妇是否存在初次感染。最近在诊断和治疗方面的进展提出了实施全国性筛查计划的问题。在为一种高发病率和高费用的疾病制定主要筛查计划之前，筛查检测必须具有安全性、可靠性和有效性，且必须有有效的和可行的干预措施。本文回顾了关于现有筛查检测和潜在干预措施的最新文献，以及在目前的科学状态下，是否符合筛查计划的标准。虽然使用 CMV 免疫球蛋白（Ig）G、IgM 和 IgG 亲和性检测筛查女性是可靠的，但通过卫生习惯改变进行有效干预或使用 CMV 特异性免疫球蛋白治疗尚未得到充分证实。在为先天性 CMV 制定筛查计划之前，需要更多来自随机对照试验的证据。
