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孕期感染细小病毒B19——我们是否要筛查传染性红斑?

Parvovirus B19 in Pregnancy-Do We Screen for Fifth Disease or Not?

作者信息

Malutan Andrei Mihai, Ormindean Cristina Mihaela, Diculescu Doru, Ciortea Razvan, Nicula Renata, Pop Daria, Bucuri Carmen, Maria Roman, Nati Ionel, Mihu Dan

机构信息

2nd Department of Obstetrics and Gynecology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.

Clinical Department of Surgery, Constantin Papilian, Emergency Clinical Military Hospital, 22 G-ral Traian Mosoiu, 400132 Cluj-Napoca, Romania.

出版信息

Life (Basel). 2024 Dec 16;14(12):1667. doi: 10.3390/life14121667.

Abstract

Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1-5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools. Vertical transmission occurs in 33% to 51% of cases of maternal infection. Parvovirus infection is an important cause of fetal perinatal infection resulting in increased morbidity through the development of fetal anemia, heart failure, and non-immune hydrops. A comprehensive literature review was conducted using PubMed, Cochrane Library, and Google Scholar, focusing on publications from the last 10 years and prioritizing studies related to parvovirus B19 infection in pregnancy. We summarized the existing data in the literature on the effects of parvovirus B19 infection during pregnancy and weighed if there is a need for screening in pregnant patients. Routine screening for parvovirus B19 infection can be considered in communities where infection is common, there is occupational exposure, or during endemic periods, with the reason being that accurate identification and treatment of fetuses affected by congenital B19V infection have been shown to improve perinatal outcomes.

摘要

细小病毒B19(B19V)感染是传染性红斑即“第五病”的病因,这是一种广泛传播的感染,可能影响1%至5%的孕妇,大多数情况下对妊娠或胎儿无明显损害。它呈现季节性变化,在温带气候中患病率较高,主要在冬末和早春。风险增加的女性包括学龄前和学龄儿童的母亲,以及在托儿所、幼儿园和学校工作的女性。33%至51%的母体感染病例会发生垂直传播。细小病毒感染是胎儿围产期感染的重要原因,可通过胎儿贫血、心力衰竭和非免疫性水肿的发展导致发病率增加。我们使用PubMed、Cochrane图书馆和谷歌学术进行了全面的文献综述,重点关注过去10年的出版物,并优先考虑与妊娠期间细小病毒B19感染相关的研究。我们总结了文献中关于妊娠期间细小病毒B19感染影响的现有数据,并权衡了对孕妇进行筛查的必要性。在感染常见、存在职业暴露或流行期间的社区,可考虑对细小病毒B19感染进行常规筛查,原因是已证明准确识别和治疗受先天性B19V感染影响的胎儿可改善围产期结局。

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