Department of Microbiology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond.
Clin Infect Dis. 2013 Dec;57 Suppl 4:S189-92. doi: 10.1093/cid/cit585.
Reported maternal-to-fetal rates of primary cytomegalovirus (CMV) infection during pregnancy have been between 30% and 50%. The highest rate of symptomatic congenital infection and sequelae occurs in about 25% of infected infants born of mothers with a primary infection during pregnancy. Symptomatic infants demonstrate a constellation of clinical features that reflect placental dysfunction and probable viral infection of the central nervous system of the fetus. In the United States, we estimate that about 8000 affected infants are born each year. Two options may be available to prevent or treat maternal CMV infection during pregnancy, especially for women with exposure to young children in the home. The first is hygienic intervention. Two studies support the simplicity, harmlessness, and effectiveness of hygienic intervention to prevent child-to-mother transmission of CMV among high-risk pregnant women who know they are susceptible. The second is CMV immunoglobulin. A meta-analysis of 2 clinical trials showed an efficacy of 50% if immunoglobulin is given to pregnant women who have acquired a primary CMV infection during pregnancy. These results mean that seronegative pregnant women have options to prevent fetal infection.
据报道，妊娠期间原发性巨细胞病毒（CMV）感染的母婴传播率在 30%至 50%之间。在妊娠期间原发性感染的母亲所生的感染婴儿中，约有 25%出现症状性先天性感染和后遗症的几率最高。有症状的婴儿表现出一系列临床特征，反映了胎盘功能障碍和胎儿中枢神经系统可能的病毒感染。在美国，我们估计每年大约有 8000 名受影响的婴儿出生。有两种选择可用于预防或治疗妊娠期间的母体 CMV 感染，尤其是对于家中有幼儿接触史的妇女。第一种是卫生干预。有两项研究支持卫生干预的简单性、无害性和有效性，可预防已知易感的高危孕妇中 CMV 从儿童到母亲的传播。第二种是 CMV 免疫球蛋白。对 2 项临床试验的荟萃分析显示，如果在妊娠期间发生原发性 CMV 感染的孕妇中使用免疫球蛋白，其有效性为 50%。这些结果意味着血清阴性的孕妇有选择来预防胎儿感染。
