Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France.
Prenat Diagn. 2013 Aug;33(8):751-8. doi: 10.1002/pd.4118. Epub 2013 May 1.
To analyze the outcome of maternal primary cytomegalovirus (CMV) infection.
Retrospective analysis of a cohort of 238 patients with maternal primary CMV infection detected at routine screening. The cases were managed with serial ultrasound (US) scans, and amniocentesis was performed in 36.1% of cases. All prenatal results were confirmed at birth.
The average age was 31.9 (18-44) years. Patients were symptomatic in 21% of cases. The rate of intrauterine transmission was 24.9%, and it was 8.8%, 19%, 30.6%, 34.1% and 40% in the preconceptional period, the periconceptional period, and the first, second and third trimesters of pregnancy, respectively (p = 0.025). There was a significantly higher risk of US abnormalities when maternal infection occurred during the preconceptional or periconceptional period and the first trimester compared with later (p < 0.001). Because of US abnormalities, pregnancy was terminated in 18 cases at the parents' request. Three infected newborns were symptomatic; all three cases were suspected at US before birth. We did not observe any symptomatic fetal infection when maternal infection occurred after 14 weeks of gestation. A number of clinically asymptomatic cases (5.5%) developed hearing loss.
The rate of materno fetal transmission is linearly correlated to the gestational age at infection. No severe case of congenital infection was observed if maternal infection occurred after 14 weeks of gestation.
分析母体原发性巨细胞病毒（CMV）感染的结局。
对常规筛查中检测到的 238 例母体原发性 CMV 感染患者进行回顾性分析。这些病例通过连续超声（US）扫描进行管理，其中 36.1%的病例进行了羊膜穿刺术。所有产前结果均在出生时得到证实。
平均年龄为 31.9（18-44）岁。21%的患者有症状。宫内传播率为 24.9%，分别在孕前、孕前期、孕早期、孕中期和孕晚期的传播率为 8.8%、19%、30.6%、34.1%和 40%（p=0.025）。与孕后期相比，孕前或孕前期以及孕早期母体感染时 US 异常的风险显著增加（p<0.001）。由于 US 异常，18 例妊娠经父母要求终止。3 例感染新生儿有症状；所有 3 例均在产前 US 检查时怀疑有感染。如果母体感染发生在妊娠 14 周后，我们没有观察到任何有症状的胎儿感染。一些临床无症状的病例（5.5%）出现听力损失。
母婴传播率与感染时的孕周呈线性相关。如果母体感染发生在妊娠 14 周后，没有观察到严重的先天性感染病例。
