Cytomegalovirus Infection among Pregnant Women in Beijing: Seroepidemiological Survey and Intrauterine Transmissions
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Primary cytomegalovirus (CMV) infection during pregnancy can cause congenital defects. Available data for CMV infection during pregnancy in north China are inadequate. The aim of this study was to evaluate the epidemiology of maternal CMV infection and explore the incidence of congenital infection. In this prospective study, serum CMV IgG and IgM antibodies were measured in 2,887 pregnant women using ELISA, and the IgG avidity test was performed on all IgM-positive subjects. The seroprevalence of anti-CMV IgG was 94.70%, and of anti-CMV IgM was 1.28%. CMV IgG prevalence increased significantly with age (p < 0.01). Women living in downtown areas showed higher IgG prevalence than those residing in urban areas (p = 0.023). CMV-IgM seroprevalence was highest in autumn (p = 0.021). There was no difference in IgM seroprevalence by age, socioeconomic status, geographical area, or gravida. The rate of primary CMV infection was 0.45% (13/2,887) at the first trimester. The seroconversion rate during pregnancy was 0.76% (22/2,887). One woman underwent seroconversion during pregnancy and gave birth to an infant with asymptomatic CMV infection. Congenital CMV infection was diagnosed in five of the 14 infants from 14 mothers with active infection, for a vertical transmission rate of 35.71% (5/14). Three infants were asymptomatic, whereas two infants presented symptomatic infection with hearing deficits. Although CMV IgG prevalence is relatively high in north China, significant attention to primary CMV infection during pregnancy is still needed.
Abstract
Primary cytomegalovirus (CMV) infection during pregnancy can cause congenital defects. Available data for CMV infection during pregnancy in north China are inadequate. The aim of this study was to evaluate the epidemiology of maternal CMV infection and explore the incidence of congenital infection. In this prospective study, serum CMV IgG and IgM antibodies were measured in 2,887 pregnant women using ELISA, and the IgG avidity test was performed on all IgM-positive subjects. The seroprevalence of anti-CMV IgG was 94.70%, and of anti-CMV IgM was 1.28%. CMV IgG prevalence increased significantly with age (p < 0.01). Women living in downtown areas showed higher IgG prevalence than those residing in urban areas (p = 0.023). CMV-IgM seroprevalence was highest in autumn (p = 0.021). There was no difference in IgM seroprevalence by age, socioeconomic status, geographical area, or gravida. The rate of primary CMV infection was 0.45% (13/2,887) at the first trimester. The seroconversion rate during pregnancy was 0.76% (22/2,887). One woman underwent seroconversion during pregnancy and gave birth to an infant with asymptomatic CMV infection. Congenital CMV infection was diagnosed in five of the 14 infants from 14 mothers with active infection, for a vertical transmission rate of 35.71% (5/14). Three infants were asymptomatic, whereas two infants presented symptomatic infection with hearing deficits. Although CMV IgG prevalence is relatively high in north China, significant attention to primary CMV infection during pregnancy is still needed.
참고문헌 (22)
- Cannon MJ, "Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection", Rev. Med. Virol, 20, pp.202~213 (2010)
- Adams WK, "Influence of infection during pregnancy on fetal development", Reproduction, 146, pp.R151~R162 (2013)
- Enders G, "Cytomegalovirus (CMV) seroprevalence in pregnant women, bone marrow donors and adolescents in Germany, 1996-2010", Med. Microbiol. Immunol, 201, pp.303~309 (2012)
- Korndewal MJ, "Cytomegalovirus infection in the Netherlands: seroprevalence, risk factors, and implications", J. Clin. Virol, 63, pp.53~58 (2015)
- Manicklal S, "The “silent” global burden of congenital cytomegalovirus", Clin. Microbiol. Rev, 26, pp.86~102 (2013)
- Revello MG, "Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant", Clin. Microbiol. Rev, 15, pp.680~715 (2002)
- Munro SC, "Diagnosis of and screening for cytomegalovirus infection in pregnant women", J. Clin. Microbiol, 43, pp.4713~4718 (2005)
- Prince HE, "Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy", Clin. Vaccine Immunol, 21, pp.1377~1384 (2014)
- Lazzarotto T, "New advances in the diagnosis of congenital cytomegalovirus infection", J. Clin. Virol, 41, pp.192~197 (2008)
- Dollard SC, "National prevalence estimates for cytomegalovirus IgM and IgG avidity and association between high IgM antibody titer and low IgG avidity", Clin. Vaccine Immunol, 18, pp.1895~1899 (2011)
- Li Z, "Prevalence of serum antibodies to TORCH among women before pregnancy or in the early period of pregnancy in Beijing", Clin. Chim. Acta, 403, pp.212~215 (2009)
- Yamamoto AY, "Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection", Epidemiol. Infect, 141, pp.2187~2191 (2013)
- Mujtaba G, "Seroprevalence of human cytomegalovirus (HCMV) infection in pregnant women and outcomes of pregnancies with active infection", J. Pak. Med. Assoc, 66, pp.1009~1014 (2016)
- Bate SL, "Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004", Clin. Infect. Dis, 50, pp.1439~1447 (2010)
- Taniguchi K, "Changes in cytomegalovirus seroprevalence in pregnant Japanese women - a 10-year single center study", J. Clin. Virol, 59, pp.192~194 (2014)
- Kouri V, "Diagnosis and screening for cytomegalovirus infection in pregnant women in Cuba as prognostic markers of congenital infection in newborns:2007-2008", Pediatr. Infect. Dis. J, 29, pp.1105~1110 (2010)
- Wang C, "Cytomegalovirus IgM seroprevalence among women of reproductive age in the United States", PLoS One, 11, pp.e0151996~ (2016)
- Zhang S, "Cytomegalovirus seroprevalence in pregnant women and association with adverse pregnancy", neonatal outcomes in Jiangsu Province, China, 2014, pp.9, e107645~
- Shigemi D, "Seroprevalence of cytomegalovirus IgG antibodies among pregnant women in Japan from 2009-2014", Am. J. Infect. Control, 43, pp.1218~1221 (2015)
- Dollard SC, "New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection", Rev. Med. Virol, 17, pp.355~363 (2007)
- Boppana SB, "Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity", N. Engl. J. Med, 344, pp.1366~1371 (2001)
- Forner G, "High cytomegalovirus (CMV) DNAemia predicts CMV sequelae in asymptomatic congenitally infected newborns born to women with primary infection during pregnancy", J. Infect. Dis, 212, pp.67~71 (2015)