孕妇孕期感染与小儿先天性心脏病关系的研究

Relationship between infections in pregnant women and congenital heart disease in neonates

目的探讨孕妇孕期感染与小儿先天性心脏病(CHD)的相关性,为降低孕期感染提供指导。方法选取医院2014年1-12月100例分娩产妇作为研究对象,将分娩CHD新生儿的产妇50例设为病例组,分娩非CHD新生儿的产妇50例为对照组,采用配对病例对照研究方法,统计分析孕妇孕期的感染情况,并采用酶联免疫吸附法检测孕妇血清中人微小病毒、弓形虫、风疹病毒、疱疹病毒及巨细胞病毒的IgG、IgM抗体水平。结果孕妇孕期感冒尤其是怀孕早期感冒、生殖道感染对新生儿CHD的发病率有显著性影响(P<0.05);而怀孕中后期感冒、流行性腮腺炎、腹泻、阑尾炎、饲养宠物等对新生儿CHD的发生无显著性影响;两组产妇在人微小病毒、弓形虫、风疹病毒的IgG抗体阳性率比较,差异有统计学意义(P<0.05);而疱疹病毒和巨细胞病毒的IgG抗体阳性率比较差异无统计学意;两组产妇血清人微小病毒、弓形虫、风疹病毒、疱疹病毒和巨细胞病毒的IgM抗体阳性检出率差异无统计学意义。结论先天性心脏病与孕妇孕期感冒(尤其是早期感冒)、生殖道感染有关,怀孕早期或怀孕前感染人微小病毒、弓形虫及风疹病毒与先天性心脏病相关。

OBJECTIVE To explore the relationship between infections in pregnant women and congenital heart disease（CHD）in neonates so as to reduce the incidence of the infections in the pregnant women.METHODS A total of 100 puerpera who gave birth from Jan 2014 to Dec 2014 were recruited as the study objects;50puerpera who gave birth to neonates with CHD were assigned as the case group,and 50 puerpera who gave birth to neonates without CHD were set as the control group.The prevalence of infections in the pregnant women was statistically analyzed by the matched case control study,and the levels of serum IgG and IgM antibodies to parvovirus,toxoplasma,rubella virus,herpes virus,and cytomegalovirus were detected by means of enzyme-linked immunosorbent assay.RESULTS The flu,especially in early pregnancy and the reproductive tract infection had significant impact on the incidence of CHD（P〈0.05）;while the flu,mumps,diarrhea,appendicitis,and feeding pets in mid and late pregnancy did not show significant impact on the incidence of CHD.There was significant difference in the positive rate of IgG antibody to parvovirus,toxoplasma,or rubella virus between the two groups of puerpera（P〈0.05）,while there was no significant difference in the positive rate of IgG antibody to herpes virus or cytomegalovirus.There was no significant difference in the positive rate of detection of serum IgM antibody to parvovirus,toxoplasma,rubella virus,herpes virus,or cytomegalovirus between the two groups of puerpera.CONCLUSION The CHD is associated with the flu（especially the flu in early pregnancy）and reproductive tract infection in the pregnant women;the infection with parvovirus,toxoplasma,or rubella virus in early pregnancy or before the pregnancy is associated with the CHD.