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孕妇巨细胞病毒 IgM 阳性时,低母体免疫球蛋白 G 亲合力和单胎妊娠与人类巨细胞病毒垂直传播的不良影响有关。

Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.

Graduate School of Nursing Science, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.

出版信息

Viruses. 2021 May 9;13(5):866. doi: 10.3390/v13050866.

Abstract

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

摘要

人巨细胞病毒(CMV)是导致婴儿神经后遗症的主要原因。了解原发性 CMV 感染的危险因素对于制定预防策略至关重要。因此,我们进行了一项回顾性队列研究,以确定免疫球蛋白(Ig)M 阳性孕妇垂直传播的危险因素。该研究纳入了 456 名 IgM 阳性孕妇。收集了年龄、产次、职业、临床症状、IgM 水平和 IgG 亲和指数(AI)等信息。将这些孕妇分为感染组和未感染组。两组在 IgM 水平、IgG AI、低 IgG AI 的孕妇数量、临床症状以及单胎孕妇数量方面存在显著差异。在多因素逻辑回归分析中,单胎和低 IgG AI 是独立的预测因素。在 40 名前次妊娠 IgG 抗体阴性的孕妇中,有 20 名在本次妊娠中 IgG AI 较低。在这 20 名孕妇中,有 4 名发生了垂直传播。这些结果为了解 IgM 阳性孕妇垂直传播的危险因素提供了更好的认识。

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