Yamada Hideto, Tairaku Shinya, Morioka Ichiro, Sonoyama Ayako, Tanimura Kenji, Deguchi Masashi, Nagamata Satoshi, Ebina Yasuhiko
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
J Infect Chemother. 2015 Mar;21(3):161-4. doi: 10.1016/j.jiac.2014.10.013. Epub 2014 Nov 11.
The aim of this survey study was to evaluate a state of mother-to-child infections in Japan.
A nationwide survey on 2714 obstetric facilities where regular maternity checkups were carried out was conducted. A primary questionnaire assessed numbers of pregnancies including induced abortion, spontaneous abortion, still-birth as well as live-birth, which were affected by congenital infections of 6 pathogens during a year of 2011. The secondary questionnaire assessed clinical information, diagnostic modality, and the outcome for each case. The clinical features and diagnostic problems were evaluated.
The high reply rates for the primary (73.7%) and the secondary questionnaire (100%) were achieved. The presence of congenital infections for 34 cases with cytomegalovirus (CMV), 1 with Toxoplasma gondii, 4 with rubella virus, 5 with Treponema pallidum, 8 with herpes simplex virus, and 69 with parvovirus B19 was confirmed after questionnaire assessment. The incidence of fetal demise among pregnancies with congenital parvovirus B19 infection was up to 71.0%. Eleven mothers with hydrops fetalis received prenatal fetal therapies involving fetal blood transfusion and immunoglobulin administration, whereas only three pregnancies (27.3%) ended in live-births.
This survey study for the first time revealed the annual frequency of pregnancies with mother-to-child infections of 6 pathogens in Japan. The results involve important information and are helpful for clinical practitioners. The majority of neonates with congenital infection of CMV or T. gondii might be undiagnosed in obstetric facilities.
本调查研究旨在评估日本母婴感染的状况。
对2714家进行常规产前检查的产科机构开展了一项全国性调查。一份初级问卷评估了包括人工流产、自然流产、死产以及活产在内的妊娠数量,这些妊娠在2011年期间受到6种病原体先天性感染的影响。次级问卷评估了每个病例的临床信息、诊断方式及结局。对临床特征和诊断问题进行了评估。
初级问卷(73.7%)和次级问卷(100%)均获得了较高的回复率。经问卷评估后,确认34例感染巨细胞病毒(CMV)、1例感染弓形虫、4例感染风疹病毒、5例感染梅毒螺旋体、8例感染单纯疱疹病毒以及69例感染细小病毒B19的先天性感染病例。先天性细小病毒B19感染的妊娠中胎儿死亡发生率高达71.0%。11例患有胎儿水肿的母亲接受了包括胎儿输血和给予免疫球蛋白在内的产前胎儿治疗,而仅有3例妊娠(27.3%)以活产告终。
这项调查研究首次揭示了日本6种病原体母婴感染妊娠的年度发生率。研究结果包含重要信息,对临床医生有帮助。大多数先天性感染CMV或弓形虫的新生儿在产科机构可能未被诊断出来。