Immunoglobulin Therapy of Fetal Cytomegalovirus Infection Occurring in the First Half of Pregnancy-A Case-Control Study of the Outcome in Children
Immunoglobulin Therapy of Fetal Cytomegalovirus Infection Occurring in the First Half of Pregnancy-A Case-Control Study of the Outcome in Children
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DOI：
10.1093/infdis/jir718
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发表时间：
2012-01-15
影响因子：
6.4
通讯作者：
Di Renzo, Gian Carlo
中科院分区：
文献类型：
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作者：
Nigro, Giovanni;Adler, Stuart P.;Di Renzo, Gian Carlo
方法.病例患者为32名1-5岁的先天性感染儿童，这些儿童有听力缺陷和/或精神发育迟滞，其母亲在妊娠< 20周时确诊或可能患有原发性CMV感染。对照组为32名先天性感染的正常儿童，其母亲在妊娠< 20周时确认原发感染。病例组患者和对照组受试者在母亲感染时的妊娠周数（+/- 1周）和评估时的儿童年龄（+/- 1岁）相匹配。对于病例患者和对照受试者，平均年龄为3.0岁。母体感染时的平均妊娠周数为11周。受影响儿童的唯一风险因素是母亲未接受免疫球蛋白（P = .001）。在32例病例中，只有4名母亲接受了CMV免疫球蛋白治疗，而对照组的32名母亲中有27名接受了CMV免疫球蛋白治疗（调整后的比值比为14 [95%置信区间为1.7-110]）。免疫球蛋白可降低精神发育迟滞和听力障碍的发生率。这些结果支持免疫球蛋白在降低妊娠期间母体感染后胎儿CMV感染引起的残疾严重程度方面的功效。
Methods. Case patients were 32 congenitally infected children aged 1-5 years who had either hearing deficit and/or psychomotor retardation and whose mothers had a confirmed or probable primary CMV infection at < 20 weeks' gestation. Control subjects were 32 congenitally infected normal children whose mothers had a confirmed primary infection at < 20 weeks' gestation. Case patients and control subjects were matched by the weeks of maternal gestation (+/- 1 week) at the mother's infection and by the child's age (+/- 1 year) at evaluation.Results. For the case patients and control subjects, the mean age was 3.0 years. The mean number of weeks of gestation at maternal infection was 11 weeks. The only risk factor for an affected child was the mother not receiving immunoglobulin (P = .001). Of the 32 case patients, only 4 mothers received CMV immunoglobulin, compared with 27 of the 32 mothers of control infants (adjusted odds ratio, 14 [95% confidence interval, 1.7-110]). The rate of both psychomotor retardation and hearing deficit decreased with immunoglobulin.Conclusions. These results support the efficacy of immunoglobulins for decreasing the severity of disabilities caused by fetal CMV infection after a primary maternal infection during pregnancy.