Toriyabe K, Morikawa F, Minematsu T, Ikejiri M, Suga S, Ikeda T
Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan.
Mie Association of Obstetricians and Gynecologists, Tsu, Japan.
J Perinatol. 2017 Dec;37(12):1272-1277. doi: 10.1038/jp.2017.133. Epub 2017 Oct 12.
We evaluated cytomegalovirus (CMV) immunoglobulin M (IgM) titer in pregnant women with primary infection as a predictive factor for congenital infection.
Maternal CMV antibody screening during the first trimester was conducted prospectively at 16 centers in Japan between September 2013 and 2015. Women with confirmed maternal primary infection underwent testing for fetal congenital infection, and we investigated the positive predictive value of CMV IgM titer levels for congenital infection in women with a low IgG avidity.
We identified 6 (8.6%) cases of congenital infection among 70 pregnant women with positive/borderline IgG, positive IgM and IgG avidity index ⩽35.0% and 11 (39.3%) among 28 women with IgG and/or IgM seroconversion. IgM titer level ⩾6.00 index showed the highest positive predictive value (17.1%).
High titer of CMV IgM during the first trimester in pregnant women with primary infection is a risk factor for congenital infection.
我们评估了初次感染的孕妇中巨细胞病毒（CMV）免疫球蛋白M（IgM）滴度作为先天性感染预测因素的情况。
2013年9月至2015年期间，在日本的16个中心对孕早期的孕妇进行了前瞻性的母体CMV抗体筛查。确诊为母体初次感染的女性接受了胎儿先天性感染检测，我们调查了低IgG亲和力女性中CMV IgM滴度水平对先天性感染阳性预测值。
在70例IgG阳性/临界值、IgM阳性且IgG亲和力指数≤35.0%的孕妇中，我们发现6例（8.6%）先天性感染病例；在28例IgG和/或IgM血清学转换的女性中，发现11例（39.3%）先天性感染病例。IgM滴度水平≥6.00指数显示出最高的阳性预测值（17.1%）。
初次感染的孕妇在孕早期CMV IgM高滴度是先天性感染的一个危险因素。
