Sfameni S F, Skurrie I J, Gilbert G L
Aust N Z J Obstet Gynaecol. 1986 Nov;26(4):257-60. doi: 10.1111/j.1479-828x.1986.tb01582.x.
The sera of 3,463 pregnant women were screened, at the first antenatal visit, for antibodies to rubella, cytomegalovirus (CMV) and Toxoplasma gondii. Rubella antibodies were detected in 97.5%, CMV antibodies in 71% and toxoplasma antibodies in 45% of women. Asymptomatic toxoplasmosis occurred during pregnancy in 3 of 609 (0.5%) and primary CMV infection in 5 of 338 (1.5%) initially seronegative women whose sera were retested at the end of their pregnancies. The observed incidence of toxoplasmosis was similar to that calculated on the basis of the age-related prevalence of antibodies found in this study. On the basis of these observations it is estimated that congenital toxoplasmosis and congenital CMV infection due to primary maternal infection each occurs in up to 2/1,000 infants in this community. Very few of these infants have obvious abnormalities at birth, but follow-up studies elsewhere have shown that many of them suffer significant long-term sequelae. Routine antenatal screening for rubella antibodies is well established and justifiable for this preventable congenital infection. However, routine antenatal screening for CMV antibodies cannot be justified at present, since neither immunization nor treatment is available. Further information is required to determine the cost-effectiveness of routine antenatal screening for toxoplasma antibodies and treatment of proven maternal infection during pregnancy.
在首次产前检查时，对3463名孕妇的血清进行了风疹、巨细胞病毒（CMV）和弓形虫抗体筛查。97.5%的女性检测到风疹抗体，71%检测到CMV抗体，45%检测到弓形虫抗体。609名孕妇中有3名（0.5%）在孕期发生无症状弓形虫感染，338名最初血清学阴性且在妊娠末期重新检测血清的孕妇中有5名（1.5%）发生原发性CMV感染。观察到的弓形虫病发病率与根据本研究中按年龄相关的抗体流行率计算出的发病率相似。根据这些观察结果估计，该社区中因母亲原发性感染导致的先天性弓形虫病和先天性CMV感染在每1000名婴儿中各有多达2例发生。这些婴儿中很少有出生时明显异常的，但其他地方的随访研究表明，其中许多人患有严重的长期后遗症。风疹抗体的常规产前筛查已得到充分确立，对于这种可预防的先天性感染是合理的。然而，目前CMV抗体的常规产前筛查尚无正当理由，因为既没有免疫方法也没有治疗方法。需要进一步的信息来确定弓形虫抗体常规产前筛查以及孕期确诊的母亲感染的治疗的成本效益。
