孕妇传染病血清流行病学监测及其优生学意义

TEH SERUM EPIDEMLOLOGICAL DETECTION OF INFECTIONS AMONG PREGNANT WOMEN AND ITS EUGENICS SIGNIFICANCE

本文旨在了解我省孕妇弓形体（Ｔｏ）、风疹（Ｒｕ）、巨细胞病毒（ＣＭＶ）及布鲁氏菌病（Ｂｒ）４种致畸传染病的感染状态及其所致出生及出生后异常情况。于１９９０年７月～１９９３年１０月对本省６市（县）部分参加围生保健的孕妇进行了血清流行病学监测（Ｔｏ、Ｒｕ、ＣＭＶ测定ＩｇＭ，Ｂｒ测定ＩｇＧ），感染率分别为Ｔｏ：３．３４％（１３８／４１２６）、Ｒｕ：０．８４％（６２／７３７５）、ＣＭＶ：１．１０％（７１／６４２８）、Ｂｒ：０．９２％（３８／４１２６）。不同年龄、孕次及孕期的妇女感染率无明显差异。Ｔｏ感染二、三季度较高，北部的新乡地区高于黄河以南地区，而Ｒｕ感染则以南部地区为高，Ｂｒ感染有明显的职业性。在３０４例阳性孕妇中有５例为交叉感染。阳性孕妇临床症状发生率为Ｔｏ：ｌｌ．５９％（ｌ６／１３８）、Ｒｕ：１２．９０％（８／６２）、ＣＭＶ：ｌｌ．２７％（８／７１）、Ｂｒ：７．８９％（３／３８）。且主要表现为上感、发热等，无明显特征。新生儿脐血抗体测定显示孕晚期及中期感染的孕妇其新生儿大部分仍保留有相关抗体，而孕早期感染者大多已消失。对２６６例阳性孕妇所生产女随访，共查出２４例异常，结果显示４种传染病所致出生及生后异常的?

n order to find out the four deforming infections of toxoplasmosis(To),rubella(Ru),cytomegalovirus(CMV)and Brucella(Br)about ther infections state and ef-fects on birth and growth,we made a serum epidemiological detection(determing IgMthrough To, Ru,CMV,IgG through Br)on pregnant women in 6 cityes(countries),HenanProvince frovince from July ,1990 to October,1993,which resulted in To :3.34%(138/4126);Ru:0.84%(62/7376);CMV:1.10%(71/6428);Br:0.92%(38/4126).No distin-guish differences of infections rate in pregnant women at various ages,times and periodswere found. Rate of To infections was higher in 2th and 3rd seasons,and higher in North(Xinxiang),lower in South(To the Yellow River):but for Ru,higher in south and Br hadan evident occupational characteristc. 5 out of 304 samples of positive pregnant women werecross infected. Clinical symptom rate of positive pregnant women was To:11.59%(16/138),Ru :12.90%(8/62),CMV: 11.27%(8/71),Br:7.89%(3/38),and showed mainly feverand upper respiratory infection。 Determination of brand-new infants′ umbilical blood anti-body showed that corresponding antibody still remained in most of the infants whose motherhad been infected during middle and late pregnancy,but disappeared from those infected inearly pregnancy.Measurements in children of 266 positive pregnant women resulted in 24abnormalities showing abnormal attributable risks between l.8%～12.7%caused by thefour infections. We tried birth intervention for the first time to abnormal idiorisks in this de-tection,8 of them put an initiative termination to pregnancy,3 of 4 had birth evident abnor-malities. The study also showed that infection in early pregnancy was much easies to causebirth abnormallty than those in middle and late.This paper also made a guess based on the study result about birth abnormalities causedby the four infections in the province and over the country.In addition,this paper also dis-cussed factors affecting the study and problems concerning the eugenics.