el-Nawawy A, Soliman A T, el Azzouni O, Karim M A, Demian S, el Sayed M
Department of Pediatrics, Alexandria College of Medicine, Egypt.
J Trop Pediatr. 1996 Jun;42(3):154-7. doi: 10.1093/tropej/42.3.154.
To determine the seroprevalence of maternal and neonatal toxoplasmosis and cytomegalovirus (CMV) antibodies and hepatitis-B (HB) antigenaemia in a rural Egyptian area, a prospective serological study was done on a randomly selected sample of pregnant women (n = 150) and their newborn infants (n = 150). Sera were collected from the mothers during the first antenatal visit, and at the time of delivery and cord blood specimens (paired samples) taken from their infants to be tested for toxoplasma-IgG and IgM antibodies, CMV-IgG and IgM antibodies surface antigen (HBsAg) and HBe antigen (HBeAg). Maternal infection was indicated in cases where specific IgM antibody was present or where an initial maternal specimen gave negative result for IgG antibody, but the second blood specimen gave positive result. Specific IgM antibody in a cord blood specimen indicated fetal infection. Out of the 150 pregnant women, 64 (43 percent) were toxoplasma immune at their first antenatal visit and their newborns were toxoplasma IgG positive. Toxoplasma specific IgM antibody was detected in only three mothers at the time of deliver. The rate of maternal infection in susceptible pregnancies was 4 percent and the maternal-fetal transmission rate was estimated to be 33 percent, as only one newborn infant had toxoplasma-IgM antibody at birth. This denoted a prevalence of congenital toxoplasma infection = < 1.0 percent to non-immune mothers. There were no clinical features of congenital infection in the infant with toxoplasma-IgM antibody, but he will require long-term follow-up. All the mothers infected during pregnancy had known risk factors for toxoplasma infection. One-hundred-and-forty-three (96 percent) of the pregnant women were CMV-IgG seropositive at their first antenatal visit. At the time of delivery 143 (96 percent) of the mothers and their newborn infants were CMV-IgG seropositive. None of the mothers or their infants was CMV-IgM seropositive. HBsAg was detected in 8 per cent of pregnant mothers (n = 12) and in two (17 percent) of their newborn infants. None of the mothers was HBeAg positive. In conclusion, the prevalence of toxoplasma infection during pregnancy and its transplacental transmission rate in a rural Egyptian area are high compared to other countries. A toxoplasmosis antenatal screening and public education programmes for pregnant mothers is justifiable in rural Egypt. However, it appears that an antenatal screening programme for CMV is, at present, not warranted.
为了确定埃及农村地区孕妇和新生儿弓形虫病、巨细胞病毒（CMV）抗体以及乙肝表面抗原血症的血清流行率，我们对随机抽取的150名孕妇及其150名新生儿进行了一项前瞻性血清学研究。在首次产前检查时采集母亲的血清，分娩时再次采集，同时采集其婴儿的脐带血标本（配对样本），检测弓形虫IgG和IgM抗体、CMV - IgG和IgM抗体、表面抗原（HBsAg）以及e抗原（HBeAg）。若存在特异性IgM抗体，或首次母亲标本IgG抗体检测为阴性但第二次血标本检测为阳性，则表明母亲感染。脐带血标本中特异性IgM抗体表明胎儿感染。150名孕妇中，64名（43%）在首次产前检查时对弓形虫具有免疫力，其新生儿弓形虫IgG呈阳性。分娩时仅在3名母亲中检测到弓形虫特异性IgM抗体。易感妊娠中母亲感染率为4%，母婴传播率估计为33%，因为出生时只有一名新生儿有弓形虫IgM抗体。这表明先天性弓形虫感染在非免疫母亲中的患病率≤1.0%。有弓形虫IgM抗体的婴儿无先天性感染的临床特征，但需要长期随访。所有孕期感染的母亲都有已知的弓形虫感染危险因素。143名（96%）孕妇在首次产前检查时CMV - IgG血清学呈阳性。分娩时，143名（96%）母亲及其新生儿CMV - IgG血清学呈阳性。母亲或其婴儿均无CMV - IgM血清学阳性。8%的孕妇（n = 12）和2名（17%）新生儿检测到HBsAg。母亲中无人HBeAg呈阳性。总之，与其他国家相比，埃及农村地区孕期弓形虫感染及其经胎盘传播率较高。在埃及农村，为孕妇开展弓形虫病产前筛查和公共教育项目是合理的。然而，目前似乎没有必要开展CMV产前筛查项目。
