Zhang Shu, Hu Lingqing, Chen Jie, Xu Biyun, Zhou Yi-Hua, Hu Yali
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Jiangsu, China.
Department of Obstetrics and Gynecology, Wuxi Maternal and Child Health Hospital, Jiangsu, China.
PLoS One. 2014 Sep 11;9(9):e107645. doi: 10.1371/journal.pone.0107645. eCollection 2014.
In this study, we aimed to determine the provincial population-based seroprevalence in pregnant women and to further explore the association of maternal CMV infection status and adverse pregnancy/neonatal/growth outcomes in Jiangsu, China.
In this case-control study, the sera from 527 pregnant women with adverse pregnancy/neonatal outcomes and 496 mothers of healthy infants in Jiangsu Province, collected at gestation age of 15-20 weeks, were tested for anti-CMV IgG, IgM and IgG avidity. Adverse pregnancy/neonatal outcomes were identified based on pregnancy/neonatal outcomes.
The overall seroprevalence of anti-CMV IgG was 98.7%, with 99.4% and 98.0% in the case and control groups, respectively (P = 0.039). The prevalence of anti-CMV IgG+/IgM+, was higher in the case group than that in the control group (3.8% vs. 1.6%, P = 0.033). Anti-CMV IgG avidity assay showed that none in the control group were primarily infected, but five (0.9%) in the case group underwent primary infection (P = 0.084); all five infants of these women presented severe adverse neonatal/growth outcomes. Exact logistic regression analysis showed that anti-CMV IgG+/IgM+ was associated with adverse pregnancy/neonatal/growth outcomes (aOR = 2.44, 95% CI 1.01-6.48, P = 0.047). Maternal low education level and prior abnormal pregnancies also were risk factors for adverse pregnancy/neonatal outcomes.
In populations with very high prevalence of latent CMV infection, active maternal CMV infection during pregnancy might be a risk factor for adverse pregnancy/neonatal outcomes.
在本研究中，我们旨在确定中国江苏省基于省级人群的孕妇血清阳性率，并进一步探讨孕妇巨细胞病毒（CMV）感染状况与不良妊娠/新生儿/生长结局之间的关联。
在这项病例对照研究中，收集了江苏省527例有不良妊娠/新生儿结局的孕妇以及496例健康婴儿母亲在妊娠15 - 20周时的血清，检测抗CMV IgG、IgM和IgG亲和力。根据妊娠/新生儿结局确定不良妊娠/新生儿结局。
抗CMV IgG的总体血清阳性率为98.7%，病例组和对照组分别为99.4%和98.0%（P = 0.039）。抗CMV IgG + /IgM + 的患病率在病例组高于对照组（3.8%对1.6%，P = 0.033）。抗CMV IgG亲和力检测显示，对照组中无原发性感染，但病例组中有5例（0.9%）发生原发性感染（P = 0.084）；这些女性的所有5例婴儿均出现严重的不良新生儿/生长结局。精确逻辑回归分析显示，抗CMV IgG + /IgM + 与不良妊娠/新生儿/生长结局相关（调整后比值比[aOR] = 2.44，95%置信区间[CI] 1.01 - 6.48，P = 0.047）。母亲低教育水平和既往异常妊娠也是不良妊娠/新生儿结局的危险因素。
在潜伏性CMV感染患病率非常高的人群中，孕期母亲CMV活动性感染可能是不良妊娠/新生儿结局的一个危险因素。
