Prevalence of viral DNA in amniotic fluid of low-risk pregnancies in the second trimester.
Prevalence of viral DNA in amniotic fluid of low-risk pregnancies in the second trimester.
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DOI：
10.1080/713605925
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发表时间：
2003-06-01
期刊：
影响因子：
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通讯作者：
Weiner, C P
中科院分区：
文献类型：
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作者：
Baschat, A A;Towbin, J;Weiner, C P
目的：胎儿病毒感染与不良妊娠结局之间的关系已有充分的文献记载。然而，常见的病毒病原体在正常妊娠的羊水中的流行率尚未确定。本研究的目的是确定这种患病率在无症状patients.METHODS：这是一个前瞻性的观察性研究的患者在低风险的病毒感染谁被称为中期妊娠遗传性卵巢囊肿穿刺术。在超声检查胎儿解剖正常且胎儿核型正常的患者中，通过多重聚合酶链反应分析在羊水穿刺术中获得的2 ml羊水等分试样中的巨细胞病毒（CMV）、细小病毒B19、腺病毒、肠道病毒、单纯疱疹病毒（HSV）、呼吸道合胞病毒（RSV）和EB病毒（EBV）。在686名患者中，高龄产妇是最常见的基因检测指征（n = 469，68.4%），其次是三联筛查中非整倍体风险升高（n = 164，23.9%），母亲血清甲胎蛋白升高（n = 20，2.9%），既往非整倍体（n = 16，2.3%）和遗传性疾病家族史（n = 14，2.1%）。44例（6.4%）羊水标本病毒基因组阳性。在41个样本中扩增了单个基因组（93%）。在三个样品中，鉴定出两种病毒基因组。腺病毒感染率最高（37/44），其次为CMV（5/44）、EBV（2/44）、肠道病毒（2/44）和RSV（1/44）。未发现细小病毒和单纯疱疹病毒。有一个双峰季节变化的患病率，在夏季和冬末的患病率最高。结论：病毒基因组是常见的羊水超声检查正常的胎儿，患病率遵循季节性模式。这种无症状病毒存在的机制、意义和影响需要进一步研究。
AIM: The association between fetal viral infection and adverse pregnancy outcome is well documented. However, the prevalence of common viral pathogens in the amniotic fluid of normal pregnancies is not established. The purpose of this study was to determine this prevalence in asymptomatic patients.METHODS: This was a prospective observational study of patients at low risk for viral infection who were referred for second-trimester genetic amniocentesis. In patients with normal fetal anatomy on ultrasound and a normal fetal karyotype, a 2-ml aliquot of amniotic fluid obtained at amniocentesis was analyzed by multiplex polymerase chain reaction for cytomegalovirus (CMV), parvovirus B19, adenovirus, enterovirus, herpes simplex virus (HSV), respiratory syncytial virus (RSV) and Epstein-Barr virus (EBV).RESULTS: Among 686 patients, advanced maternal age was the most common indication for genetic testing (n = 469, 68.4%), followed by elevated aneuploidy risk on triple screen (n = 164, 23.9%), elevated maternal serum alpha-fetoprotein (n = 20, 2.9%), previous aneuploidy (n = 16, 2.3%) and family history of inheritable disease (n = 14, 2.1%). Forty-four (6.4%) amniotic fluid samples were positive for viral genome. A single genome was amplified in 41 samples (93%). In three samples, two viral genomes were identified. Adenovirus was most frequently identified (37/44), followed by CMV (5/44), EBV (2/44), enterovirus (2/44) and RSV (1/44). Parvovirus and HSV were not identified. There was a bimodal seasonal variation in prevalence, with the highest prevalence during the summer and late winter.CONCLUSION: Viral genome is commonly found in amniotic fluid with a sonographically normal fetus, and the prevalence follows a seasonal pattern. The mechanism, significance and effects of this asymptomatic viral presence require further study.