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目的 :探讨HCMV发生孕期活动性感染、引起宫内传播及对胎儿、婴儿影响的相关因素。方法 :ELISA孕前筛查HCMV -IgM、IgG抗体并分 4组。用ELISA和PCR两种技术跟踪检测孕妇早、中、晚孕期外周血、羊水及新生儿脐带血感染情况、对新生儿行跟踪调查。结果 :孕前育龄妇女活动性感染率为 10 .2 % ;孕前 4组感染类型发生在孕期活动性感染率高达2 4 .1% ,以原发、复发组发生率最高占孕期活动性感染的 75 % ;孕期活动性感染自然流产率显著高于非活动性感染组 ;孕期活动性感染发生官内感染的危险度为 3 4 .6% ;孕期活动性感染新生儿先天性感染检出率为 8 9% ;发生在孕早期活动性感染妊娠结局最为严重。结论 :孕前感染类型与孕后发生活动性感染危险度密切相关 ,且不同类型对妊娠结局影响不同 ;孕期活动性感染自然流产率高 ,能够引起官内垂直传播 ;胎盘及母体的特异性IgG抗体对胎儿的保护作用不可忽视 ;重点预防早孕期CMV感染
Objective: To investigate the related factors of HCMV active infection during pregnancy, causing intrauterine transmission and its impact on fetus and infants. Methods: HCMV-IgM and IgG antibodies were screened before pregnancy and divided into 4 groups. The detection of umbilical cord blood infection in peripheral blood, amniotic fluid and newborn during early, middle and late pregnancy in pregnant women was followed up by ELISA and PCR. Results: Pre-pregnancy active infection rate of women of childbearing age was 10.2%. The infection types of the four groups before pregnancy were as high as 24.1% during pregnancy, with the highest prevalence in active and recurrent groups accounting for 75% of active infections during pregnancy %; Spontaneous abortion during pregnancy spontaneous abortion rate was significantly higher than inactive infection; active infection during pregnancy with the risk of intra-organ infection was 34.6%; active infection in pregnancy congenital infection rate of neonatal infection was 8 9%; occurred in the first trimester active infection pregnancy outcome is the most serious. CONCLUSION: The type of infection before pregnancy is closely related to the risk of active infection after pregnancy, and different types have different effects on pregnancy outcome. The rate of spontaneous abortion during pregnancy is high and can cause vertical transmission in the government. The specific IgG antibodies to placenta and maternal The protection of the fetus can not be ignored; focus on prevention of early pregnancy CMV infection