BEHAVIORAL INTERVENTION FOR CONGENITAL CMV DISEASE

描述：研究人员建议使用行为矫正 在怀孕期间，以防止儿童向母亲传播一种常见的 巨细胞病毒（CMV）。 这一点很重要，因为每年 CMV宫内感染导致多达8,000名婴儿精神 弱智和/或失聪 这是因为没有免疫力的母亲 （血清反应阴性）幼儿参加日托的年发病率为 感染率每年接近50%，相比之下， 在不与日托幼儿日常接触的妇女中所占百分比。 如果血清阴性的妇女在怀孕期间获得CMV， 四分之三的血清反应阴性的母亲在怀孕后， 30个月以下的儿童在集体日托中。 至少15 %的儿童正在脱落CMV。 调查人员已 完成了两项试点研究，以确定行为改变是否会减少 CMV的母婴传播 他们发现， 干预不太可能对非妊娠妇女有效，但可能 对孕妇非常有效。 为了确定孕妇相对风险的真正降低， 通过行为干预来确定动机因素是否 血清反应阴性的孕妇了解其孩子是否正在脱落 将从200个日托中心招募CMV血清阴性孕妇 在美国的五个城市， 一个对照组或者两个教育组中的一个。 的母亲 对照组和一个教育组没有被告知他们的孩子是否 脱落巨细胞病毒 另一个教育组的母亲知道她们孩子的 status. 两个教育组的母亲将得到以下指导： 保护行为（经常洗手，戴乳胶手套）和风险 避免的行为（与孩子的亲密接触）。 手套和肥皂的使用 将进行监测，以间接客观衡量遵守 保护行为。 母亲自我报告的保护和 在整个研究过程中的危险行为。 这次审判的结果将 确定行为干预的有效性和动机 有必要遵守建议，防止儿童对母亲 CMV的传播。

DESCRIPTION: The investigators propose to use behavioral modification during pregnancy to prevent the child-to-mother transmission of a common virus called cytomegalovirus (CMV). This is important because annually intrauterine infection with CMV causes up to 8,000 infants to be mentally retarded and/or deaf. This occurs because mothers without immunity (seronegative) with young children attending day care have annual rates of infection of nearly 50 percent per year compared to a rate of less than five percent among women not in daily contact with young children in day care. Fetal damage occurs if seronegative women acquire CMV during pregnancy and three quarters of seronegative mothers who conceive another child do so with a previous child under 30 months of age in group day care. At least 15 percent of these children are shedding CMV. The investigators have completed two pilot studies to determine if behavioral modification reduced child-to-mother transmission of CMV. They found that behavioral intervention was unlikely to be effective for nonpregnant women but likely to be highly effective for pregnant women. To determine the true reduction in relative risk for pregnant women afforded by behavioral intervention and to determine whether a motivational factor is knowledge by seronegative pregnant mother of whether her child is shedding CMV, seronegative pregnant women will be recruited from 200 day care centers in five cities in the United States and randomly assigned by day care center to either a control group or one of two education groups. Mothers in the control group and one education group are not told whether if their child is shedding CMV. Mothers in the other education group know their child's status. Mothers in both education groups will be given instructions about protective behaviors (frequent hand washing, wearing latex gloves) and risky behaviors to avoid (intimate contact with the child). Glove and soap use will be monitored for an indirect objective measure of adherence to the protective behaviors. Mothers self-report percentages of protective and risky behaviors throughout the study. The results of this trial will determine the effectiveness of behavioral intervention and the motivation necessary to adhere to recommendations and prevent child-to-mother transmission of CMV.