Prenatal indicators of congenital cytomegalovirus infection
Prenatal indicators of congenital cytomegalovirus infection
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DOI：
10.1067/mpd.2000.107110
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发表时间：
2000-07-01
影响因子：
5.1
通讯作者：
Landini, AP
中科院分区：
文献类型：
--
作者：
Lazzarotto, T;Varani, S;Landini, AP
目的：评估一项诊断方案的有效性，该方案旨在预测妊娠前4个月内疑似原发性巨细胞病毒（CMV）感染母亲的新生儿的结局。通过酶免疫测定和免疫印迹法检测抗CMV免疫球蛋白（IG）M，并测定抗CMV IgG亲和力，我们将456名妇女分为：（1）未感染，（2）经历原发性或复发性感染，或（3）具有不确定的血清学状况。产前诊断在妇女妊娠21至23周时进行。在羊水中的病毒的存在下，通过培养，聚合酶链反应，定量聚合酶链反应，宏观和组织学检查进行流产胎儿的组织，而新生儿的文化进行尿液采样在第一周的生命。定量测定羊水中至少10（3）个基因组当量的CMV DNA，可100%确定检测到感染的胎儿。较高的病毒载量与胎儿或新生儿的症状。结论：IgM抗体测试和IgG抗体亲和力测定可以确定所有妇女在传播巨细胞病毒的风险此外，高CMV DNA载量在羊水中可能是一个指标的症状性先天性感染在怀孕的相对早期阶段。
Objective: To assess the validity of a diagnostic protocol designed to predict the outcome of newborns of mothers suspected to have primary cytomegalovirus (CMV) infection during the first 4 months of pregnancy.Study design: Anti-CMV immunoglobulin (Ig) M detection by enzyme immunoassay and immunoblot together with the determination of anti-CMV IgG avidity allowed us to classify 456 women as (1) uninfected, (2) undergoing either a primary or a recurrent infection, or (3) having an undefined serologic condition. Prenatal diagnosis was carried out at 21 to 23 weeks' gestation for women. The presence of the virus in the amniotic fluid was determined by culture, polymerase chain reaction, and quantitative polymerase chain reaction, Macroscopic and histologic examinations were undertaken on tissue from aborted fetuses, whereas for newborns culture was performed on urine sampled during the first week of life.Results: Congenital infections were found exclusively among women undergoing a primary infection. The quantitative determination of CMV DNA in the amniotic fluid of at least 10(3) genome equivalents gave a 100% certainty of detecting an infected fetus. Higher viral loads were associated with fetuses or newborns with symptoms.Conclusions: IgM tests and the IgG avidity determination can identify all women at risk of transmitting CMV Furthermore, a high CMV DNA load in amniotic fluid could be an indicator of symptomatic congenital infection at a relatively early stage of pregnancy.