河南省新密市孕妇及新生儿巨细胞病毒感染流行特征分析

Epidemiology of CMV Infection in Pregnant Women and Newborns in Xinmi, Henan Province, China

本研究旨在分析中国河南省新密市孕妇巨细胞病毒(Cytomegalovirus, CMV)血清流行特征,及新生儿先天性CMV(CCMV)感染特征,为将来CCMV感染预防奠定基础。2015年至2017年,河南省新密市妇幼保健院开展了一项前瞻性队列研究,对于孕早期在本院进行建卡产检的孕妇连续招募入组,分别在孕早期、孕中期及孕晚期采集其血液标本进行CMV-IgG检测。孕妇分娩后,采集新生儿唾液和尿液标本开展CMV-DNA检测,进行CCMV筛查和确认性检测。新密市孕妇CMV抗体阳性率为97.80%(3594/3 675,95%CI:97.27%~98.25%),人群抗体阳性率、抗CMV~IgG抗体水平均随年龄有上升趋势。在抗体阳性孕妇中,孕早期IgG几何平均抗体浓度为11.10IU/mL(95%CI:10.80 IU/mL~11.41 IU/mL);在抗体阴性孕妇中,孕期抗体阳转率为11.39%(9/79,95%CI:4.39%~18.40%)。新密市CCMV估算感染率为1.33%(49.28/3694,95%CI:1.01%~1.76%),97.92%CCMV新生儿来自孕早期抗体阳性孕妇。河南省新密市孕妇CMV抗体阳性率极高,新生儿CCMV感染率也较高。CMV抗体阳性率与抗体水平均随着孕妇年龄有上升趋势。

This study analyzed the characteristics of CMV seroprevalence in pregnant women, and congenital cytomegalovirus(CCMV) infection in newborns, to provide evidence for future CCMV infection control. From 2015 to 2017, a prospective cohort study was conducted in Xinmi Maternal and Child Health Hospital. Pregnant women at their first antenatal visits were consecutively enrolled and collected and blood samples were collected for CMV-IgG detection in the early, middle, and late stages of pregnancy. After delivery, saliva and urine of newborns were collected for CMV-DNA detection to screen and confirm CCMV infection. The CMV seroprevalence was 97.80%(3,594/3,675, 95%CI, 97.27%-98.25%) in pregnant women in Xinmi,China;both seroprevalence and IgG GMC increased with maternal age. In seropositive pregnant women, IgG GMC was 11.10 IU/mL(95%CI, 10.80-11.41 IU/mL) at early pregnancy;in seronegative pregnant women, the seroconversion rate was 11.39%(9/79, 95%CI, 4.39%-18.40%). The estimated CCMV incidence was 1.33%(49.28/3,694, 95%CI, 1.01%-1.76%). Additionally, 97.92% of CCMV newborns were from seropositive pregnant women. In Xinmi,China. the CMV seroprevalence in pregnant women was extremely high, and the CCMV prevalence in newborns was also relatively high. Both seroprevalence and IgG GMC increased with maternal age.