Yamada Hideto, Tairaku Shinya, Morioka Ichiro, Ebina Yasuhiko, Sonoyama Ayako, Tanimura Kenji, Deguchi Masashi, Nagamata Satoshi
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Congenit Anom (Kyoto). 2014 May;54(2):100-3. doi: 10.1111/cga.12044.
Mother-to-child infections cause congenital infection with disease and sequelae. To evaluate a state of maternal blood screening for mother-to-child infections in Japan, we for the first time conducted a nationwide survey on obstetric facilities where regular maternity checkups were carried out. A questionnaire assessment involved an annual number of deliveries, scale of facilities and a state of maternal blood screening for eight pathogens. A high rate (73.7%) of reply to the questionnaire was achieved from 1990 facilities, covering 75.1% of annual number of delivery in 2011. The performance rates of blood screening were more than 99% for rubella virus, Treponema pallidum, human immunodeficiency virus (HIV), human T cell leukemia virus type 1 (HTLV-1), hepatitis B virus, and hepatitis C virus, while the rate was found to be only 4.5% for cytomegalovirus (CMV), and 48.5% for Toxoplasma gondii with large differences in regions. Most of the facilities performed blood tests for rubella virus, Treponema pallidum, HIV, hepatitis B virus and hepatitis C virus once in early pregnancy, while approximately 28% of the facilities performed blood tests for HTLV-1 once during the 2nd or 3rd trimester. Most of the facilities used HA tests for Toxoplasma gondii, whereas there was a wide variation in antibody measurement methods for CMV. Generally, the obstetric facilities in Japan have performed maternal blood screening properly according to the current recommendations. The results of this survey involve important information and are helpful for clinical practitioners.
母婴感染会导致先天性感染及相关疾病和后遗症。为评估日本母婴感染的母体血液筛查状况,我们首次对开展定期产前检查的产科机构进行了全国性调查。问卷调查评估内容包括年分娩量、机构规模以及针对八种病原体的母体血液筛查状况。来自1990家机构的问卷回复率很高(73.7%),覆盖了2011年分娩总量的75.1%。风疹病毒、梅毒螺旋体、人类免疫缺陷病毒(HIV)、人类嗜T淋巴细胞病毒1型(HTLV-1)、乙型肝炎病毒和丙型肝炎病毒的血液筛查执行率均超过99%,而巨细胞病毒(CMV)的筛查率仅为4.5%,弓形虫的筛查率为48.5%,且地区差异较大。大多数机构在孕早期对风疹病毒、梅毒螺旋体、HIV、乙型肝炎病毒和丙型肝炎病毒进行一次血液检测,而约28%的机构在妊娠中期或晚期对HTLV-1进行一次血液检测。大多数机构对弓形虫采用HA检测,而CMV抗体检测方法差异很大。总体而言,日本的产科机构已根据当前建议妥善开展了母体血液筛查。本次调查结果包含重要信息,对临床医生很有帮助。