An epidemic of parvovirus B19 in a population of 3596 pregnant women: a study of sociodemographic and medical risk factors
An epidemic of parvovirus B19 in a population of 3596 pregnant women: a study of sociodemographic and medical risk factors
复制标题
DOI：
10.1111/j.1471-0528.2000.tb13306.x
复制
发表时间：
2000-05-01
期刊：
影响因子：
--
通讯作者：
Vestergaard, BF
中科院分区：
文献类型：
--
作者：
Jensen, IP;Thorsen, P;Vestergaard, BF
目的估计流行前和流行期间孕妇中人细小病毒B19的发病率，阐明妊娠期间可能的社会人口统计学和医学危险因素，并估计细小病毒B19感染与妊娠不良结局之间的关系。设计对孕妇进行前瞻性研究，从妊娠24周前的第一次产前检查到分娩。背景：丹麦欧登塞大学医院妇产科，1992年11月至1994年2月。方法对3596名孕妇进行问卷调查。这些妇女在1992年11月至1994年2月期间的第一次产前检查和分娩时进行了检查。最后一次交付是在1994年8月，因此样本是在1994年1月至9月丹麦细小病毒B19大流行之前和期间收集的。登记时采集细小病毒B19血清学血样，分娩时采集脐带血样。在第二和第三孕期完成三份调查问卷，并在分娩时填写一份登记表。共有3174人（87.6%）入组，其中79.5%完成了研究。结果妊娠24周前首次产前检查血清b19 IgG阳性率为66%。IgG阴性妇女妊娠期急性细小病毒B19感染的累积流行率为10.3% （IgM血清阳性和/或IgG血清转化）。932名血清阴性孕妇的IgG血清转化率在疫情前和疫情期间分别从1.0%上升至13.5% （P < 0.001）。经其他社会人口统计学和医学因素调整后，与妊娠期b19感染风险增加相关的独立危险因素为：家中有儿童（调整OR为2.1,95% CI为1.3-3.2）；严重内科疾病（校正OR 3.0, 95% CI 1.0-8.5）；工作压力大（调整比值比1.8,95%可信区间1.0-3.3）。细小病毒B19 IgM血清阳性与晚期自然流产和死产事件相关（粗比值为9.9；95% CI为3.3-29.4）。结论妊娠妇女急性B19感染流行前和流行期间的发病率分别为1.0%和13.5%。三个显著增加急性B19风险的因素被确定为：家中有孩子；患有严重疾病的；工作压力大。细小病毒B19 IgM阳性与妊娠不良结局相关。
Objectives To estimate the incidence of human parvovirus B 19 among pregnant women before and during an epidemic, to elucidate possible sociodemographic and medical risk factors during pregnancy and to estimate the association between parvovirus B19 infection and negative pregnancy outcome.Design Prospective study among pregnant women followed from their first antenatal visit before 24 full weeks of gestation until delivery.Setting Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark, November 1992 to February 1994.Methods 3596 pregnant women were invited to participate. The women were examined at first antenatal visit in the period from November 1992 to February 1994 and at delivery. The last delivery was in August 1994 and samples were thus collected before and during a large parvovirus B19 epidemic in Denmark January to September 1994. A blood sample for parvovirus B19 serology was taken at enrolment and from the umbilical cord at delivery. Three questionnaires were completed during 2nd and 3rd trimesters and a registration form at delivery. In total, 3174 (87.6%) were enrolled and 79.5% completed the study.Results The prevalence of B 19 IgG seropositivity at the first antenatal Visit before 24 full weeks of gestation was 66%. The cumulative prevalence proportion of acute parvovirus B19 infection during pregnancy among IgG negative women was found to be 10.3% (IgM seropositivity and/or IgG seroconversion). The IgG seroconversion incidence increased significantly from 1.0% to 13.5% among 932 seronegative pregnant women before and during the epidemic, respectively (P < 0.001). Independent risk factors related to increased risk of B 19 infection during pregnancy, adjusted for other sociodemographic and medical factors, were: children at home (adjusted OR 2.1, 95 % CI 1.3-3.2); serious medical disease (adjusted OR 3.0, 95% CI 1.0-8.5); and a stressful job (adjusted OR 1.8, 95% CI 1.0-3.3). Parvovirus B19 IgM seropositivity was associated with events of late spontaneous abortions and stillbirths (crude OR 9.9; 95% CI 3.3-29.4).Conclusion Before and during an epidemic of acute B19 infection incidences were measured among pregnant women to be 1.0% and 13.5%, respectively. Three factors, significantly increasing the risk of acute B19, were identified as: having children at home; suffering from serious medical diseases; and having a stressful job. IgM positivity for parvovirus B19 was associated with negative outcome of pregnancy.