Brown H L, Abernathy M P
Division of Maternal Fetal Medicine, Indiana University School of Medicine, Indianapolis, USA.
Semin Perinatol. 1998 Aug;22(4):260-6. doi: 10.1016/s0146-0005(98)80014-1.
Cytomegalovirus (CMV) infection is the most common perinatal infection and may result in severe injury to the fetus. Forty percent to 50% of infants delivered to mothers with primary CMV will have congenital infections. Of these, 5% to 18% will be overtly symptomatic at birth. The mortality rate in these children is almost 30%; approximately 80% of the survivors have severe neurological morbidity. The majority of congenitally infected infants will be asymptomatic at birth; 10% to 15% of these children subsequently have sequelae such as visual and auditory defects. If recurrent or reactivated CMV infection develops during pregnancy, the risk of serious fetal injury is very low. Similarly, neonatal infection acquired during delivery or from breast feeding also poses minimal risk to the child. Because antimicrobial therapy and immunoprophylaxis for CMV infection are unsatisfactory, pregnant women must be educated about preventive measures.
巨细胞病毒(CMV)感染是最常见的围产期感染,可能导致胎儿严重损伤。原发性CMV感染母亲所分娩的婴儿中,40%至50%会发生先天性感染。其中,5%至18%在出生时会有明显症状。这些儿童的死亡率近30%;约80%的幸存者有严重的神经疾病。大多数先天性感染婴儿出生时无症状;其中10%至15%的儿童随后会出现视力和听力缺陷等后遗症。如果孕期发生CMV复发或再激活感染,严重胎儿损伤的风险非常低。同样,分娩期间或母乳喂养获得的新生儿感染对儿童的风险也极小。由于CMV感染的抗菌治疗和免疫预防效果不佳,必须对孕妇进行预防措施教育。