先天性巨细胞病毒与回顾性基于人群的研究中严重形式的脑瘫和女性性别有关。
Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population-based study.
机构信息
Discipline of Paediatrics & Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Centre for Perinatal Infection Research or Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia; Cerebral Palsy Alliance Research Institute, University of Notre Dame Australia, Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia.
出版信息
Dev Med Child Neurol. 2014 Sep;56(9):846-52. doi: 10.1111/dmcn.12467. Epub 2014 Apr 19.
AIM
Congenital cytomegalovirus (cCMV) infection can result in poor outcomes including cerebral palsy (CP). The aim of this study was to describe the incidence and comorbidities of CP reported to the Australian Cerebral Palsy Register (ACPR) as attributed to cCMV infection.
METHOD
This was a retrospective population-based study. Cases were drawn from Australian state CP registers with population level ascertainment, 1993 to 2003 (n=2265; 56.4% males, Gross Motor Function Classification System [GMFCS] ratings available for Victorian cases only: 70% GMFCS levels I to III and 30% GMFCS levels IV to V). Clinical data were extracted and cases with cCMV reported as a known cause were compared with cases where cCMV was not reported.
RESULTS
Children with cCMV (n=34; 12 males, 22 females; mean [SD] gestational age, 36.4 wk [4.4], range 24-41 wk) accounted for 1.5% of CP cases; 2.9 per 100,000 live births, (95% confidence intervals 1.9-3.9). When compared with CP cases where cCMV was not reported, proportionally, more CP cases with cCMV were born to younger mothers (p<0.001), were female (64% vs 43%, p=0.014), had spastic quadriplegia (73% vs 21%, p<0.001), required wheeled mobility i.e. GMFCS IV or V (78% vs 28%, p<0.001), had epilepsy (70% vs 30%, p<0.001), deafness (40% vs 2%, p<0.001), functional blindness (20% vs 5%, p<0.001), and severe communication impairment (71% vs 25%, p<0.001).
INTERPRETATION
cCMV is an important potentially preventable cause of CP and is associated with severe disability and female sex in cases reported to the ACPR. Future studies utilising prospective sample collection for cCMV testing are needed to confirm these findings.
目的
先天性巨细胞病毒（cCMV）感染可导致不良结局，包括脑瘫（CP）。本研究旨在描述归因于 cCMV 感染的澳大利亚脑瘫登记处（ACPR）报告的 CP 发病率和合并症。
方法
这是一项回顾性基于人群的研究。病例来自澳大利亚各州的脑瘫登记处，采用人群水平确定方法，时间为 1993 年至 2003 年（n=2265；男性占 56.4%，仅维多利亚州的病例有粗大运动功能分类系统[GMFCS]评分：70%GMFCS 水平 I 至 III 和 30%GMFCS 水平 IV 至 V）。提取临床数据，并将报告 cCMV 为已知病因的病例与未报告 cCMV 的病例进行比较。
结果
患有 cCMV 的儿童（n=34；男性 12 例，女性 22 例；平均[SD]胎龄 36.4wk[4.4]，范围 24-41wk）占 CP 病例的 1.5%；每 100,000 例活产儿中有 2.9 例（95%置信区间 1.9-3.9）。与未报告 cCMV 的 CP 病例相比，cCMV 阳性 CP 病例中，母亲年龄较小的比例更高（p<0.001），女性（64%比 43%，p=0.014），痉挛性四肢瘫（73%比 21%，p<0.001），需要轮椅移动即 GMFCS IV 或 V（78%比 28%，p<0.001），癫痫（70%比 30%，p<0.001），耳聋（40%比 2%，p<0.001），功能性失明（20%比 5%，p<0.001），严重沟通障碍（71%比 25%，p<0.001）。
解释
cCMV 是 CP 的一个重要的、潜在可预防的病因，与 ACPR 报告的病例中严重残疾和女性性别有关。未来需要利用前瞻性样本收集进行 cCMV 检测的研究来证实这些发现。
Zotero 插件