孕前及孕期妇女风疹免疫力调查和风疹近期感染检测

Investigation about the immune level of rubella and infection of rubella in before-pregnant women and pregnant women

目的了解孕前妇女及孕期妇女风疹易感水平和近期感染状况,为预防先天风疹感染做好优生优育工作提供依据。方法用生物蛋白芯片技术对2986例孕前妇女及863例孕期妇女(包括725例正常妊娠和138例异常妊娠)进行风疹特异性抗体IgM、IgG检测。结果80.27%的孕前妇女具有免疫力,4.99%孕前妇女为风疹近期感染,14.03%妇女对风疹易感。89.00%的孕期妇女具有免疫力,1.96%孕期妇女为风疹近期感染,7.76%妇女对风疹易感。孕前妇女及孕期妇女的风疹近期感染率和易感率比较有显著性差异(χ2=14.797、23.846,P<0.001);不良妊娠与正常妊娠之间风疹近期感染率和易感率比较有显著性差异(χ2=30.635、4.174,P<0.05);市区与农村的孕前妇女及孕期妇女在风疹近期感染率和易感率比较无明显不同;孕前妇女及孕期妇女风疹近期感染月份分布均以5月最高。结论本地区孕前妇女风疹感染率高;风疹感染与不良妊娠密切相关:市区与农村妇女的风疹易感水平和近期感染状况相当。对孕前妇女及孕期妇女同时检测风疹特异性抗体IgM、IgG可以正确判定妇女的免疫状况,有效预防、主动发现并合理处理孕妇感染,从而降低风疹感染率提高优生优育水平。

Objective： To know the rubella susceptibility and rubella infection situation in before -pregnant women and pregnant women, and provide scientific basis for controlling congenital rubella syndrome. Methods ： To detect rubella - specific IgG and IgM, 2986 before -pregnant women and 863 pregnant women （138 with abnormal pregnancy and 725 with normal pregnancy） were tested by Gene chip technology. Results： 80.27% before -pregnant women had resistance against rubella, based on positive rubella- specific IgG. 4. 99% cases were primary infection, based on positive rubella- specific IgM. 14. 03% cases were susceptible to rubella, based on negative rubella -specific IgG and IgM; 89. 00% pregnant women had resistance against rubella, 1.96% cases were primary infection, 7.76% cases were susceptible to rubella, the rate of rubella susceptibility and rubella infection had significant difference between before - pregnant women and pregnant women （ χ^2= 14. 797, 23. 846, P 〈 0. 001 ）. The rate of rubella susceptibility in the abnormal pregnant women was significantly higher than that in the normal pregnant women, meanwhile, the rate of rubella infection in the abnormal pregnant women was significantly lower than that inthe normal pregnant women （χ^2 = 30. 635, 4. 174, P 〈 0. 05 ）. The rate of rubella susceptibility and rubella infection had no significant difference between urban women and rural women. The month distributions of recent rubella infection in before - pregnant women and pregnant women are both the highest in May. Conclusion： Linqing area has high rubella infection in before - pregnant women ; recent rubella infection is closely relative to abnormal pregnancy; rubella susceptibility and rubella infection situation had no significant difference between urban women and rural women. Detection of both IgM and IgG in before - pregnant women will help evaluate immune status of women, and so will reduce the incidence of congenital rubella syndrome.