Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases
Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases
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DOI：
10.1002/pd.940
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发表时间：
2004-07-01
影响因子：
3
通讯作者：
Enders, G
中科院分区：
文献类型：
--
作者：
Enders, M;Weidner, A;Enders, G
目的探讨不同孕周孕妇细小病毒B19感染对胎儿并发症的影响，方法对1018例经血清学确诊的孕妇进行前瞻性观察。（95%置信区间[CI]：4.9 8.0）。妊娠前20周内感染的胎儿死亡率为64/579（11.0%）。仅当母体B 19感染发生在完成20 WG之前时观察到胎儿死亡。观察到的死胎比例为0.6%（6/960）。6例死胎中3例出现胎儿水肿。胎儿水肿的总体风险为3.9%（40/1018）（95% CI：2.8，5.3）。17例非重度积液中3例接受宫腔输血，23例重度积液中13例接受宫腔输血。胎儿输血后存活的重度水肿胎儿比例为11/13（84.6%）。所有的非输血胎儿严重hydrops.Conclusion胎儿死亡的相关B19相关的风险，这在很大程度上是局限于母亲B19感染的前20个WG。重度水肿胎儿及时宫内输血可降低胎儿死亡风险。细小病毒B19相关的死胎无水肿介绍是不常见的发现。版权所有（C）2004约翰威利父子有限公司。
Objective To determine more precisely the incidence of fetal complications following maternal parvovirus B19 infection at various gestational ages.Methods An observational prospective study of 1018 pregnant women whose acute B19 infection was serologically confirmed in our laboratory.Results The observed rate of fetal death throughout pregnancy was 6.3% (64/1018) (95% confidence interval [CI]: 4.9 8.0). The fetal death rate for those infected within the first 20 weeks of gestation (WG) was 64/579 (11.0%). Fetal death was only observed when maternal B 19 infection occurred before the completed 20 WG. The observed stillbirth proportion was 0.6% (6/960). Three of six stillbirth cases presented with fetal hydrops. The overall risk of hydrops fetalis was 3.9% (40/1018) (95% CI: 2.8, 5.3). Three of 17 cases with non-severe hydrops and 13 of 23 cases with severe hydrops received intrauterine transfusion(s). The proportion of fetuses with severe hydrops that survived following fetal transfusions was 11/13 (84.6%). All of the non-transfused fetuses with severe hydrops died.Conclusion Our data demonstrate a relevant B19-associated risk of fetal death, which is largely confined to maternal B19 infection in the first 20 WG. Timely intrauterine transfusion of fetuses with severe hydrops fetalis reduces the risk of fetal death. Parvovirus B19-associated stillbirth without hydropic presentation is not a common finding. Copyright (C) 2004 John Wiley Sons, Ltd.