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小于 34 孕周孕妇巨细胞病毒抗体和新生儿先天性巨细胞病毒感染的流行率:一项前瞻性研究。

Prevalence of Maternal Cytomegalovirus Antibodies and Neonatal Congenital Cytomegalovirus at Less than 34 Weeks of Gestation: A Prospective Study.

机构信息

Department of Neonatology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.

Department of NICU Nutritionist, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.

出版信息

Am J Perinatol. 2024 May;41(S 01):e648-e653. doi: 10.1055/s-0042-1756641. Epub 2022 Oct 19.

Abstract

OBJECTIVE

Congenital cytomegalovirus (cCMV) acquired postnatally can lead to hearing loss and adverse central nervous system (CNS) function, especially in the preterm neonate. We prospectively determined the prevalence of maternal serum CMV-immunoglobulin (IgG) and the incidence of cCMV at <34 weeks of gestation.

STUDY DESIGN

Study was conducted in the United States and India. Maternal blood was collected within 5 days after delivery. CMV-IgG antibodies were quantitated by an immunoassay. Baby's urine at birth was tested for CMV-DNA by the polymerase chain reaction.

RESULTS

In total, 65 women and 74 neonates were studied. In the United States, 6 out of 21 (76%), while in India, 42 out of 44 (96%) mothers were seropositive (combined 89%). In the United States, none of the neonates had CMV in the urine, while in India 4 out of 52 (7.7%) were positive (combined 5.4%) CONCLUSION:  Mother's blood and baby's urine should be tested for serum CMV-IgG antibodies and CMV-DNA at delivery at <34-weeks of gestational age. Targeted screening will help in making an early diagnosis of cCMV, initiate therapy, and detect and treat early CNS problems including hearing loss.

KEY POINTS

· Maternal serum CMV screening after premature delivery at less than 34 weeks of gestation.. · Neonatal urine CMV screening at less than 34 weeks of gestation.. · Prematurity: importance of CMV during premature labor and delivery at less than 34 weeks..

摘要

目的

出生后获得的先天性巨细胞病毒(cCMV)可导致听力损失和不良的中枢神经系统(CNS)功能,尤其是在早产儿中。我们前瞻性地确定了<34 周妊娠时母体血清 CMV-免疫球蛋白(IgG)的流行率和 cCMV 的发生率。

研究设计

该研究在美国和印度进行。分娩后 5 天内采集母亲的血液。通过免疫测定定量测定 CMV-IgG 抗体。婴儿出生时的尿液通过聚合酶链反应检测 CMV-DNA。

结果

总共研究了 65 名妇女和 74 名新生儿。在美国,21 名母亲中有 6 名(76%),而在印度,44 名母亲中有 42 名(96%)为血清阳性(合计 89%)。在美国,没有新生儿的尿液中存在 CMV,而在印度,52 名新生儿中有 4 名(7.7%)为阳性(合计 5.4%)。

结论

<34 周妊娠时,应检测母亲的血液和婴儿的尿液以进行血清 CMV-IgG 抗体和 CMV-DNA 检测。有针对性的筛查将有助于早期诊断 cCMV,启动治疗,并检测和治疗早期 CNS 问题,包括听力损失。

重点

·小于 34 周妊娠时早产母亲血清 CMV 筛查。·小于 34 周妊娠时新生儿尿液 CMV 筛查。·早产:小于 34 周早产和分娩时 CMV 的重要性。

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