Maternal IgG avidity, IgM and ultrasound abnormalities: combined method to detect congenital cytomegalovirus infection with sequelae
Maternal IgG avidity, IgM and ultrasound abnormalities: combined method to detect congenital cytomegalovirus infection with sequelae
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DOI：
10.1038/jp.2013.87
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发表时间：
2013-11-01
影响因子：
2.9
通讯作者：
Ikenoue, T.
中科院分区：
文献类型：
--
作者：
Kaneko, M.;Sameshima, H.;Ikenoue, T.
目的：我们使用母亲的免疫球蛋白M（IgM），免疫球蛋白G（IgG）的亲和力指数（AI）和胎儿超声检查（US），以有效地检测先天性巨细胞病毒感染的胎儿，将遭受神经系统后遗症出生后STUDY DESIGN：检测方法是前瞻性的适应1163例孕妇。在第一次产前检查（妊娠10.8 +/- 2.2周）时测量IgM、IgG和IgG-AI。在我中心对IgM阳性的妇女进行了高级US。应用聚合酶链反应（PCR）检测1163例新生儿尿液。结果：大多数妇女（83.3%）血清学阳性。其中IgM阳性40例（4.1%）。9/40例（22.5%）AI低，其中1例超声异常，并有严重后遗症。其余8名婴儿的超声检查正常;然而，1名婴儿有听力障碍。另有3名受感染的婴儿发育正常。其母亲血清学检查结果：IgM阳性，AI高（n = 1），IgG阳性，IgM阴性，AI高（n = 1），IgG和IgM均阴性（n = 1）。然而，问题仍然是检测感染的胎儿，只有听力障碍。
OBJECTIVE: We used maternal immunoglobulin M (IgM), immunoglobulin G (IgG) avidity index (AI) and fetal ultrasonography (US) to effectively detect a congenital cytomegalovirus-infected fetus that would suffer neurological sequelae after birth.STUDY DESIGN: The detecting method was prospectively adapted to 1163 unselected pregnant women. IgM, IgG and IgG-AI were measured at the first prenatal examination (10.8 +/- 2.2 weeks of gestation). Advanced US was performed for the IgM-positive women at our center. The urine of 1163 neonates was examined via PCR. All infected neonates were followed for neurological development.RESULT: Most women (83.3%) were seropositive. Among them, 40 (4.1%) were IgM positive. Nine of forty (22.5%) had low AI, of which one showed abnormal US and suffered severe sequelae. The remaining eight had a normal US; however, one infant had hearing impairment. There were another three infected infants with normal development. Their mothers' serological results were: IgM positive with high AI (n = 1); IgG positive; IgM negative with high AI (n = 1); and both IgG and IgM negative (n = 1).CONCLUSION: This method enabled us to detect infected fetuses having severe sequelae. However, the problem remains of detecting infected fetuses that only have a hearing impairment.