妊娠原发性巨细胞病毒感染和先天性感染：基于人群的母婴前瞻性队列研究。
Primary cytomegalovirus infection during pregnancy and congenital infection: a population-based, mother-child, prospective cohort study.
机构信息
Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Mie Association of Obstetricians and Gynecologists, Tsu, Mie, Japan.
出版信息
J Perinatol. 2021 Oct;41(10):2474-2481. doi: 10.1038/s41372-021-01157-9. Epub 2021 Jul 20.
OBJECTIVE
This study assessed maternal cytomegalovirus antibodies, and the occurrence of primary and congenital cytomegalovirus infections, and risk factors of congenital infection after a maternal primary infection.
STUDY DESIGN
We included 19,435 pregnant women in Japan, who were tested for serum cytomegalovirus antibodies before 20 gestational weeks. Immunoglobulin (Ig) G avidity was evaluated in women with both IgG and IgM antibodies; tests were repeated at ≥28 gestational weeks among women without IgG and IgM antibodies.
RESULT
Primary and congenital infections were 162 and 23 cases, respectively. The risk ratios for congenital infection were 8.18 (95% confidence interval: 2.44-27.40) in teenage versus older women, and 2.25 (95% confidence interval: 1.28-3.94) in parity ≥ 2 versus parity ≤ 1. Of 22 live birth congenital infection cases, three had abnormal neurological findings.
CONCLUSION
We demonstrated teenage and parity ≥ 2 pregnant women as risk factors of post-primary congenital infection.
目的
本研究评估了母体巨细胞病毒抗体以及原发性和先天性巨细胞病毒感染的发生情况，以及母体原发性感染后先天性感染的危险因素。
研究设计
我们纳入了日本的 19435 名孕妇，她们在 20 孕周前检测了血清巨细胞病毒抗体。对 IgG 和 IgM 抗体均阳性的妇女进行 IgG 亲和性评估；在 IgG 和 IgM 抗体均阴性的妇女中，在≥28 孕周时重复进行检测。
结果
原发性和先天性感染分别为 162 例和 23 例。与年龄较大的妇女相比，青少年（风险比：8.18，95%置信区间：2.44-27.40）和产次≥2 次（风险比：2.25，95%置信区间：1.28-3.94）的妇女发生先天性感染的风险比更高。在 22 例活产先天性感染病例中，有 3 例存在神经发育异常。
结论
我们发现青少年和产次≥2 是原发性感染后先天性感染的危险因素。
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