孝感市单中心高危新生儿先天性巨细胞病毒感染率及高病毒载量危险因素分析

Analysis on congenital cytomegalovirus infection rate and risk factors of high viral load of high-risk newborns in Xiaogan City Single Center

目的调查孝感地区高危新生儿中先天性巨细胞病毒(cytomegalovirus,CMV)感染状况并分析其高病毒载量的危险因素。方法选取2018年1月至2020年12月武汉科技大学附属孝感医院新生儿科收治的高危新生儿作为研究对象,留取尿液标本行CMV-DNA定量聚合酶链式反应(polymerase chain reaction,PCR)检测,计算感染率。根据定量PCR检测病毒DNA载量分为高载量组和低载量组,比较两组临床资料,采用多因素Logistic回归分析筛查高危新生儿中先天性CMV感染高病毒DNA载量的独立危险因素。结果武汉科技大学附属孝感医院收治的高危新生儿中,先天性CMV感染率约为7.0%(172/2448)。两组在孕妇居住地、羊水有无异常方面差异有统计学意义(均P<0.05)。多因素Logistic回归分析提示,孕妇居住在农村、羊水异常增加了高危新生儿先天性CMV感染后高病毒DNA载量的风险(均P<0.05)。结论孝感地区高危新生儿中先天性CMV感染率相对较高,应加强区域孕期保健管理及分娩后CMV筛查,尤其是农村孕妇,羊水异常者。

Objective To investigate the infections of congenital cytomegalovirus(CMV)of high-risk newborns in Xiaogan City,and to analyze the risk factors of such high viral load.Methods High-risk newborns admitted to the Department of Neonatology,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to December 2020 were selected as the research subjects,urine samples were collected for CMV-DNA quantitative polymerase chain reaction(PCR)detection,and the infection rate was calculated.The newborns were divided into high-load group and low-load group based on quantitative PCR detection of viral DNA load.The clinical data of the two groups were compared,and multivariate Logistic regression analysis was applied to analyze and screen out the independent risk factors of congenital CMV infection and high viral DNA load in high-risk newborns.Results The infection rate of congenital CMV in high-risk newborns admitted to Xiaogan Hospital Affiliated to Wuhan University of Science and Technology was approximately 7.0%(172/2448).The differences between two groups in terms of the residence place of pregnant women and presence or absence of abnormal amniotic fluid were statistically significant(all P<0.05).Multivariate Logistic regression analysis showed that the risk of congenital CMV infection and high viral DNA load in high-risk newborns was elevated among pregnant women living in rural areas and abnormal increase in amniotic fluid(all P<0.05).Conclusion The infection rate of congenital CMV of high-risk newborns is relatively high in high-risk newborns treated in Xiaogan.Regional health care management during pregnancy and CMV screening after delivery,especially rural pregnant women and those with abnormal amniotic fluid should be strengthened.