Division of Developmental and Behavioral Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA.
Division of Pathology, Ascension Hospital Providence, Southfield, MI 48075, USA.
Viruses. 2024 Sep 30;16(10):1552. doi: 10.3390/v16101552.
The objective was to review the existing literature reporting on spontaneous abortion (SA) and intrauterine fetal demise (IUFD) associated with cytomegalovirus (CMV) infection. A review using standardized terminology such as 'intrauterine fetal death', 'congenital cytomegalovirus' and 'CMV' was performed using PubMed and Embase (Medline) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Twenty-one studies met inclusion criteria. CMV was identified as a potential or likely factor in a median of 7.1% of SA or IUFD in study cohorts. Of the studies, 11 used fetal remains, 18 used placenta, 6 used serum, and 1 used post-mortem dried blood spot as specimens for testing for CMV. Features commonly observed were fetal thrombotic vasculopathy, hydrops fetalis and chronic villitis. CMV is frequently noted in studies evaluating viral etiologies of SA or IUFD. Large population-based studies are needed to estimate the incidence of CMV-associated SA or IUFD. CMV and congenital CMV should be included on the differential diagnosis in all cases of SA or IUFD of unknown etiology.
目的是回顾现有的文献报告，报告与巨细胞病毒 (CMV) 感染相关的自然流产 (SA) 和宫内胎儿死亡 (IUFD)。使用标准化术语，如“宫内胎儿死亡”、“先天性巨细胞病毒”和“CMV”，使用 PubMed 和 Embase (Medline) 进行综述，采用系统评价和荟萃分析的首选报告项目 (PRISMA) 方法。符合纳入标准的研究有 21 项。在研究队列中，CMV 被确定为 SA 或 IUFD 的潜在或可能因素，中位数为 7.1%。在这些研究中，11 项使用了胎儿残骸，18 项使用了胎盘，6 项使用了血清，1 项使用了死后干血斑作为 CMV 检测的标本。常见的特征是胎儿血栓血管病变、胎儿水肿和慢性绒毛膜炎。在评估 SA 或 IUFD 的病毒病因的研究中，CMV 经常被注意到。需要进行大型基于人群的研究来估计与 CMV 相关的 SA 或 IUFD 的发生率。在所有原因不明的 SA 或 IUFD 中，CMV 和先天性 CMV 都应列入鉴别诊断。
