育龄妇女弓形虫、风疹病毒和巨细胞病毒感染现状及其与不良妊娠结局的相关性研究

Investigation on status of toxoplasma,rubella virus and cytomegalovirus infection in childbearing-age women and its relationship with adverse pregnancy outcomes

目的研究重庆地区育龄妇女弓形虫（TOX）、风疹病毒（RV）及巨细胞病毒（CMV）的感染状况,并初步探讨其与不良妊娠结局的关系。方法收集2013年9-11月在重庆市某区妇幼保健院进行免费孕前检查的2 009例育龄妇女的血清标本,采用酶联免疫吸附试验（ELISA）检测TOX、RV、CMV感染相关抗体,并对研究对象进行问卷调查,统计TOX、RV和CMV的感染情况,并分析其与不良妊娠结局史的关系。结果 2 009例研究对象中88例有死胎、死产史,占4.4%;249例有自然流产史,占12.4%。TOX和CMV的总累计感染率分别为2.2%、15.1%,总新发感染率分别为1.0%、0.4%,RV-IgG总阳性率为13.6%;不同年龄组间TOX、RV、CMV感染率比较差异均有统计学意义（P〈0.05）。TOX、RV和CMV感染是死胎、死产的危险因素（P〈0.05）,OR值分别为2.9、3.4、7.8;RV和CMV感染是自然流产的危险因素（P〈0.05）,OR值分别为1.4、2.5。结论重庆地区育龄妇女TOX、RV、CMV感染率偏高,是导致死胎、死产和自然流产的重要原因,应加强该地区育龄妇女尤其是20-30岁育龄妇女孕前TOX、RV、CMV筛查。

Objective To investigate the current status of toxoplasma（TOX）,rubella virus（RV）and cytomegalovirus（CMV）infection among childbearing-age women in Chongqing area and to preliminarily explore its relationship with the adverse pregnancy outcomes.Methods Serum samples of 2 009childbearing-age women receiving free pre-pregnancy checks in a District Maternity and Child Health Care Centers of Chongqing were collected from Sep.to Nov.2013.The enzyme-linked immunosorbent assay（ELISA）was used to detect TOX,RV and CMV related antibodies in serum samples,and all participants were surveyed by questionnaire.The status of TOX,RV and CMV infection in childbearing-age women and its relationship with the adverse pregnancy outcomes were statistically analyzed.Results Of all 2 009childbearing-age women,88participants（4.4%）had the history of stillbirth,and 249participants（12.4%）had the history of spontaneous abortion.The total accumulative infection rates of TOX and CMV were2.2%and 15.1%respectively,and the total new infection rates were 1.0%and 0.4%respectively.The total positive rate of RV-IgG was 13.6%.There were statistically significant differences in the TOX,RV,CMV infection rates among the different age groups（P〈0.05）.TOX,RV and CMV infections were the risk factors of stillbirth（P〈0.05）,the odds ratio（OR）values were 2.9,3.4and 7.8respectively.The RV and CMV infections were the risk factors of spontaneous abortion,and the ORvalues were 1.4and 2.5respectively.Conclusion The infection rates of TOX,RV and CMV were on the high side and were the important risk factors leading to stillbirth and spontaneous abortion.Therefore the pregestation screening of TOX,RV and CMV should be strengthened among childbearing-age women in this area,especially for those aged 20-30 years old.