Adler S P, Finney J W, Manganello A M, Best A M
Department of Pediatrics, Medical College of Virginia, Richmond 23298-0163, USA.
Pediatr Infect Dis J. 1996 Mar;15(3):240-6. doi: 10.1097/00006454-199603000-00013.
To determine whether a behavioral prevention approach reduces child-to-parent transmission of cytomegalovirus.
Subjects were seronegative mothers whose child was less than 36 months of age and was shedding cytomegalovirus. Nonpregnant women were randomly assigned to three groups. Mothers in the education group (E) were given instructions about protective behaviors (frequent hand washing, wearing latex gloves) and risky behaviors to avoid (intimate contact with the child). Disposable diapers, liquid soap and latex gloves were provided. During biweekly home visits glove and soap use were monitored for an indirect objective measure of adherence to the protective behaviors. Throughout the study mothers self-reported the frequency they engaged in protective and risky behaviors. In addition to the procedures for Group E the adherence and education group (A) also received social reinforcement for adherence and problem solving for any perceived problems with the behavioral recommendations. The control group (C) received no intervention. A fourth group of pregnant women received an intervention equivalent to that of the education group.
Eight of 17 women in Group C and 4 of 11 women in Group E seroconverted. For both E and Group C the average time from enrollment to infection was 4 months (range, 2 to 7 months). Two of 8 women in Group A seroconverted (1 at 3 months and 1 at 8 months). None of 14 pregnant women observed for an average of 8.4 months during pregnancy seroconverted.
These results suggest that intervention for pregnant women is effective because pregnant women will perceive a higher risk and be more motivated to adhere to recommendations than nonpregnant women.
确定一种行为预防方法是否能减少巨细胞病毒从儿童向父母的传播。
研究对象为血清学阴性的母亲，其孩子年龄小于36个月且正在排出巨细胞病毒。未怀孕的女性被随机分为三组。教育组（E）的母亲接受了关于保护行为（勤洗手、戴乳胶手套）和应避免的危险行为（与孩子密切接触）的指导。提供了一次性尿布、液体肥皂和乳胶手套。在每两周一次的家访中，监测手套和肥皂的使用情况，以间接客观地衡量对保护行为的依从性。在整个研究过程中，母亲们自我报告她们从事保护行为和危险行为的频率。除了E组的程序外，依从性与教育组（A）还因依从性获得了社会强化，并针对行为建议中任何察觉到的问题进行问题解决。对照组（C）未接受干预。第四组孕妇接受了与教育组相同的干预。
C组17名女性中有8名、E组11名女性中有4名发生了血清转化。E组和C组从入组到感染的平均时间均为4个月（范围为2至7个月）。A组8名女性中有2名发生了血清转化（1名在3个月时，1名在8个月时）。14名孕妇在孕期平均观察8.4个月，均未发生血清转化。
这些结果表明，对孕妇的干预是有效的，因为与未怀孕的女性相比，孕妇会意识到更高的风险，并且更有动力遵守建议。
