Dogan Keziban, Kafkasli Ayse, Kaya Cihan, Cengiz Huseyin
Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, İstanbul, Turkey.
Department of Obstetrics and Gynecology, Özel Erdem Hastanesi, İstanbul, Turkey.
Eurasian J Med. 2013 Jun;45(2):88-91. doi: 10.5152/eajm.2013.19.
The rates of seropositivity, seroconversion and fetal infection with human cytomegalovirus were analyzed in pregnant women and newborn cord blood in this study. The relationships between maternal age, parity, cytomegalovirus serology and polymerase chain reaction results were evaluated.
A total of 217 pregnant women attended our pregnancy clinic between April 2004 and October 2005. During each trimester, 5 cc of maternal blood was obtained and 5 cc of cord blood was collected after birth. An enzyme-linked immunosorbent assay (ELISA) was used to assess these samples for the presence of human cytomegalovirus protein pp65 antigen (in leukocytes) and cytomegalovirus DNA (in plasma).
The mean age of the pregnant women in our study was 28.1±5.3 years. No seroconversion was observed. Among the pregnant women, 212 (97.7%) were IgG positive, and 29 (13.4%) were IgM positive. Five of the pregnant women were positive for IgM alone (2.3%), whereas 24 (11.3%) were positive for both IgM and IgG. The 29 IgM-positive patients were reevaluated using the polymerase chain reaction, and no seropositivity was found. None of the cord blood samples were IgM positive, whereas 211 (97.3%) were IgG positive. There was no significant correlation between parity and seropositivity (p=0.487). The relationship between human cytomegalovirus seropositivity and maternal age was evaluated by dividing the pregnant women into two groups, with a cut-off age of 35 years. There was a significant difference in seropositivity between these two groups (p=0.045).
Clearly, there is no need to screen pregnant women for Human cytomegalovirus (HCMV) in the Malatya region. Confirming serology results using the polymerase chain reaction and antigenemia testing to detect false positive results offers the advantage of avoiding unnecessary invasive interventions.
本研究分析了孕妇及新生儿脐带血中人巨细胞病毒的血清阳性率、血清转化情况及胎儿感染情况。评估了产妇年龄、产次、巨细胞病毒血清学及聚合酶链反应结果之间的关系。
2004年4月至2005年10月期间,共有217名孕妇到我们的孕期诊所就诊。在每个孕期,采集5毫升母体血液,出生后采集5毫升脐带血。采用酶联免疫吸附测定法(ELISA)评估这些样本中是否存在人巨细胞病毒蛋白pp65抗原(白细胞中)和巨细胞病毒DNA(血浆中)。
本研究中孕妇的平均年龄为28.1±5.3岁。未观察到血清转化情况。在孕妇中,212例(97.7%)IgG阳性,29例(13.4%)IgM阳性。5例孕妇仅IgM阳性(2.3%),而24例(11.3%)IgM和IgG均阳性。对29例IgM阳性患者进行聚合酶链反应重新评估,未发现血清阳性。脐带血样本中无一例IgM阳性,而211例(97.3%)IgG阳性。产次与血清阳性之间无显著相关性(p=0.487)。将孕妇分为两组,以35岁为分界年龄,评估人巨细胞病毒血清阳性与产妇年龄之间的关系。这两组之间的血清阳性率存在显著差异(p=0.045)。
显然,在马拉蒂亚地区没有必要对孕妇进行人巨细胞病毒(HCMV)筛查。使用聚合酶链反应和抗原血症检测来确认血清学结果以检测假阳性结果,具有避免不必要的侵入性干预的优势。