Cradock-Watson J E, Ridehalgh M K, Anderson M J, Pattison J R
J Hyg (Lond). 1981 Oct;87(2):147-54. doi: 10.1017/s0022172400069345.
We have tried to detect prenatal infection in 34 infants whose mothers were re-infected with rubella virus during pregnancy and in six infants whose mothers had primary subclinical rubella during pregnancy. Two methods of assessment were used: first, serum obtained soon after birth was tested for IgM antibody; secondly, serum obtained after the age of 8 months was tested for specific IgG. The 34 women with re-infections had increases in IgG antibody titre but no IgM response. No evidence of prenatal infection was found in 33 of their 34 infants. One infant was found to have IgG antibody at the age of 11 months. This infant was IgM-negative at birth and had a rubelliform rash at the age of 5 1/2 months; it therefore probably contracted post- rather than pre-natal infection. Fetal infection from maternal re-infection during pregnancy is probably rare. The six women with primary subclinical rubella produced both IgG and IgM classes of antibody. Three of their six infants showed serological evidence of intrauterine infection. One, infected when its mother was 8 weeks pregnant, had clinical evidence of congenital rubella. Primary subclinical rubella during pregnancy therefore carries a significant risk of fetal infection. Because of the difference in outcome, great care should be taken to distinguish between primary infection and re-infection when investigating symptomless increases in antibody titre after contact with rubella during pregnancy.
我们试图对34名母亲在孕期再次感染风疹病毒的婴儿以及6名母亲在孕期初次感染亚临床型风疹的婴儿进行产前感染检测。采用了两种评估方法：第一，检测出生后不久采集的血清中的IgM抗体；第二，检测8个月龄后采集的血清中的特异性IgG。34名再次感染的女性IgG抗体滴度升高，但无IgM反应。在她们的34名婴儿中，33名未发现产前感染证据。一名婴儿在11个月龄时被发现有IgG抗体。该婴儿出生时IgM阴性，5个半月时出现风疹样皮疹；因此，它可能是在出生后而非产前感染。孕期母亲再次感染导致胎儿感染可能很少见。6名初次感染亚临床型风疹的女性产生了IgG和IgM两类抗体。她们的6名婴儿中有3名有宫内感染的血清学证据。其中一名在其母亲怀孕8周时被感染，有先天性风疹的临床证据。因此，孕期初次感染亚临床型风疹会给胎儿感染带来很大风险。由于结果不同，在调查孕期接触风疹后无症状的抗体滴度升高时，应格外注意区分初次感染和再次感染。
