Kang Han, Wang Lingxi, Chen Yifei, Dong Ting, Pan Yuchun, Liu Qingsong
Prenatal diagnosis department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, 1617 RiYue Road, Chengdu, China.
BMC Infect Dis. 2025 Apr 16;25(1):542. doi: 10.1186/s12879-025-10910-w.
To explore the application value of serology testing and fetal ultrasound examination in screening for fetal cytomegalovirus(CMV) infection. To explore the application value of CMV polymerase chain reaction (PCR) in amnio fluids in prenatal diagnosis of fetal CMV infection.
This is a retrospective study performed at Chengdu Women's and Children's Central Hospital between 2021 and 2024. The baseline of preconception CMV infections and recent infections were investigated via serology testing. Pregnant women with suspicious serology for recent infection and/or ultrasound abnormalities suggestive of fetal infection underwent amniocentesis to obtain amniotic fluid for CMV PCR. The pregnancy outcomes of women with suspicious serology for recent infection and those who underwent amniocentesis were analyzed.
The seroprevalence was 95.65%(55262/57778) and 0.99%(571/57778) for immunoglobulin G(IgG) and immunoglobulin M (IgM) antibodies respectively. Among the 315 pregnant women with positive IgM results who performed CMV IgG avidity index and/or dynamic IgM/ IgG tests, only 2.22%(7/315) confirmed recent infection and 2.54%(8/315) suspected recent infection: three terminated pregnancies including one with positive CMV PCR results and two with other reasons, and 12 gave birth to asymptomatic babies. 576 pregnant women with suspicious serology for recent infection and/or ultrasound abnormalities suggestive of fetal infection performed CMV PCR in amniotic fluid. Among them, we got 438 pregnancy outcomes, including 25 terminated pregnancies, eight stillbirths, and 405 live births. None of the 405 live births had symptoms related to CMV infection at birth, except two with mild hearing loss without known cause. Four fetal infections were diagnosed, including three who performed amniocentesis and CMV PCR and one accidentally diagnosed by copy number variation sequencing(CNV-seq). Three of them were negative for IgM in first-trimester screening.
Ultrasound screening plays a more important role than serology screening in areas with a high seroprevalence of CMV antibodies. Assays for both chromosome disorders and CMV PCR in amniotic fluids should be suggested to pregnant women with ultrasound abnormalities suggestive of fetal infection.
探讨血清学检测及胎儿超声检查在胎儿巨细胞病毒（CMV）感染筛查中的应用价值。探讨CMV聚合酶链反应（PCR）在羊水检测中对胎儿CMV感染产前诊断的应用价值。
本研究为回顾性研究，于2021年至2024年在成都市妇女儿童中心医院开展。通过血清学检测调查孕前CMV感染及近期感染的基线情况。近期感染血清学检测可疑和/或超声检查提示胎儿感染的孕妇接受羊膜腔穿刺术获取羊水进行CMV PCR检测。分析近期感染血清学检测可疑孕妇及接受羊膜腔穿刺术孕妇的妊娠结局。
免疫球蛋白G（IgG）和免疫球蛋白M（IgM）抗体的血清阳性率分别为95.65%（55262/57778）和0.99%（571/57778）。在315例IgM结果阳性并进行CMV IgG亲和力指数和/或动态IgM/IgG检测的孕妇中，仅2.22%（7/315）确诊近期感染，2.54%（8/315）疑似近期感染：3例终止妊娠，其中1例CMV PCR结果阳性，2例因其他原因；12例分娩出无症状婴儿。576例近期感染血清学检测可疑和/或超声检查提示胎儿感染的孕妇进行了羊水CMV PCR检测。其中，获得438例妊娠结局，包括25例终止妊娠、8例死产和405例活产。405例活产儿中，除2例原因不明的轻度听力损失外，出生时均无与CMV感染相关的症状。诊断出4例胎儿感染，其中3例进行了羊膜腔穿刺术和CMV PCR检测，1例通过拷贝数变异测序（CNV-seq）意外诊断。其中3例在孕早期筛查时IgM为阴性。
在CMV抗体血清阳性率较高的地区，超声筛查比血清学筛查发挥更重要的作用。对于超声检查提示胎儿感染的孕妇，建议同时进行染色体疾病检测和羊水CMV PCR检测。
