Song Xinli, Li Qiongxuan, Diao Jingyi, Li Jinqi, Li Yihuan, Zhang Senmao, Chen Letao, Wei Jianhui, Shu Jing, Liu Yiping, Sun Mengting, Sheng Xiaoqi, Wang Tingting, Qin Jiabi
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
National Health Committee (NHC) Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
Front Pediatr. 2022 Mar 17;10:803568. doi: 10.3389/fped.2022.803568. eCollection 2022.
Given that the time lag between cytomegalovirus (CMV) screening and diagnosed testing, a better knowledge of the association between pregnant women with CMV screening test positive and stillbirth in an epidemiological perspective was required to assist people being counseled reframe their pregnancy and birth plans based on the magnitude of the risk.
This study recruited 44048 eligible pregnant women from March 13, 2013 to December 31, 2019. Serological tests including CMV-specific IgM and IgG, and IgG avidity index were used to screen for maternal CMV infection and were measured by automated chemiluminescence immunoassay. The association was assessed using the inverse probability of group-weighted multivariate-adjusted log-binomial models.
A total of 540 infants ended with a stillbirth (12.3 per 1000 pregnancies), and 2472 pregnancies with maternal CMV infection were screened out (56.1 per 1000 pregnancies) among all eligible pregnancies. In the comparison analysis, 326 infants ended with a stillbirth (86.6 per 1000 pregnancies) in the maternal CMV infection group compared with 214 infants (7.8 per 1000 pregnancies) in the group where mothers were not infected with CMV (RR 12.17; 95% CI 9.43-15.71). After excluding the pregnancies of stillbirth with birth defects, a strong association between the two groups was still observed (RR 9.38; 95% CI 6.92-12.70).
Our findings quantified the risk of a woman having a baby with stillbirth if she had a positive serologic CMV screening test in her first trimester, and supported the value of using CMV serologic tests as part of regular testing in pregnant women.
Registered in Chinese Clinical Trial Registry Center; registration number, ChiCTR1800016635; registration date, 06/14/2018 (Retrospectively registered); URL of trial registry record, https://www.chictr.org.cn/showproj.aspx?proj=28300.
鉴于巨细胞病毒（CMV）筛查与确诊检测之间存在时间差，从流行病学角度更好地了解CMV筛查试验呈阳性的孕妇与死产之间的关联，有助于接受咨询的人们根据风险程度重新规划其妊娠和分娩计划。
本研究纳入了2013年3月13日至2019年12月31日期间44048名符合条件的孕妇。采用包括CMV特异性IgM和IgG以及IgG亲和力指数在内的血清学检测方法，通过自动化学发光免疫分析来筛查孕妇CMV感染情况，并进行检测。采用组加权多变量调整对数二项模型评估两者之间的关联。
在所有符合条件的妊娠中，共有540例婴儿以死产告终（每1000例妊娠中有12.3例），筛查出2472例孕妇感染CMV（每1000例妊娠中有56.1例）。在比较分析中，CMV感染孕妇组中有326例婴儿以死产告终（每1000例妊娠中有86.6例），而母亲未感染CMV的组中有214例婴儿（每1000例妊娠中有7.8例）（相对风险12.17；95%置信区间9.43 - 15.71）。排除伴有出生缺陷的死产妊娠后，两组之间仍观察到强关联（相对风险9.38；95%置信区间6.92 - 12.70）。
我们的研究结果量化了妊娠早期血清学CMV筛查试验呈阳性的女性产下死产婴儿的风险，并支持将CMV血清学检测作为孕妇常规检测一部分的价值。
在中国临床试验注册中心注册；注册号，ChiCTR1800016635；注册日期，2018年6月14日（追溯注册）；试验注册记录的网址，https://www.chictr.org.cn/showproj.aspx?proj=28300 。
