CONGENITAL AND MATERNAL CYTOMEGALOVIRUS INFECTIONS IN A LONDON POPULATION
CONGENITAL AND MATERNAL CYTOMEGALOVIRUS INFECTIONS IN A LONDON POPULATION
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DOI：
10.1111/j.1471-0528.1991.tb13358.x
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发表时间：
1991-02-01
期刊：
影响因子：
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通讯作者：
PECKHAM, C
中科院分区：
文献类型：
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作者：
GRIFFITHS, PD;BABOONIAN, C;PECKHAM, C
目的-确定是否可以在产前识别出有婴儿感染巨细胞病毒（CMV）风险的妇女。设计-孕妇的前瞻性血清学和人口学研究及其新生儿的病毒学研究。地点-伦敦教学医院。受试者-3315名孕妇及其婴儿2737名。主要结果指标-CMV IgG抗体的定量检测； CMV IgM 抗体定性检测；母亲的人口统计特征；新生儿巨细胞病毒病毒的定性和定量滴定。结果-9名新生儿（0.33%）发现先天性巨细胞病毒感染，其中两人出现症状。 对九名母亲进行的血清学检测显示四名原发感染和五名复发感染；两名有症状的儿童均出生于后一组。 检测早孕血清中的 CMV 特异性 IgM 抗体或定量 IgG 抗体无法将那些有可能生出被 CMV 感染或受损的婴儿的妇女与其他人群区分开来。 病毒尿定量证实，那些最有感染巨细胞病毒疾病风险的婴儿具有最高的巨细胞病毒滴度。结论-(i)由于孕妇的实验室检测不能可靠地识别有患病风险的胎儿，因此不建议筛查无症状母体感染并终止妊娠。 (ii) 由于“免疫”的妇女仍然可以生出受 CMV 感染的婴儿，因此我们建议未来应使用 CMV 疫苗对儿童进行免疫，以根除 CMV 感染为目的，优先于对血清敏感的女性进行选择性免疫。
Objective-To determine if women at risk of having babies infected with cytomegalovirus (CMV) can be identified antenatally.Design-Prospective serological and demographic study of pregnant women and virological study of their newborn infants.Setting-Teaching hospital in London.Subjects-3315 pregnant women and 2737 of their babies.Main outcome measures-Quantitative detection of CMV IgG antibodies; qualitative detection of CMV IgM antibodies; demographic characteristics of mothers; qualitative and quantitative titration of CMV viruria in newborn.Results-Congenital CMV infection was found in nine newborn babies (0.33%) two of whom had symptoms. Serological testing of the nine mothers showed four primary and five recurrent infections; both of the symptomatic children were born in the latter group. Testing for CMV specific IgM antibodies or quantitation of IgG antibodies in early pregnancy sera could not differentiate those women at risk of giving birth to babies infected or damaged by CMV from the rest of the population. Quantitation of viruria confirmed that those babies most at risk of CMV disease have the highest titres of CMV.Conclusions-(i) Since laboratory tests in pregnant women cannot reliably identify fetuses at risk of disease, screening for asymptomatic maternal infection coupled with termination of pregnancy cannot be recommended. (ii) Since 'immune' women can still give birth to babies affected by CMV, we propose that future CMV vaccines should be used to immunize children with the aim of eradicating CMV infection in preference to selective immunization of sero-susceptible females.