孕早期原发性巨细胞病毒感染对胎、婴幼儿的影响

采用酶联免疫吸附试验及多聚酶链反应技术对孕早期肯定为原发性巨细胞病毒感染的20例孕妇进行前瞻性研究，并与中、晚期诊断为再发感染及既往感染的孕妇胎、婴幼儿进行对照研究，发现原发感染者其宫内垂直传播率为75．0％（15／20），活产新生儿先天性感染率为66．67％（10／15），胎儿宫内发育迟缓发生率为20．0％，死胎、畸形的出现率分别为5．0％（1／20）、10．0％（2／20），均明显高于再发感染及既往感染组。采用贝利发育量表对10例原发感染组、13例再发感染组及34例既往感染组孕妇所出生的婴幼儿进行检测，结果表明原发感染组的婴幼儿智力发育指数明显低于再发感染及继往感染组（P＜0．05），精神运动发育指数三者之间差异无显著意义（P＞0．05）。提示孕早期原发性巨细胞病毒感染对胎、婴幼儿影响多而且严重，孕早期原发性巨细胞病毒感染的筛查极为重要。

The Effects of Primary Cytomegalovirus Infection on Fetal and Infant Development in Early Pregnancy

Twenty pregnent women with primary human cytomegalovirus (HCMV) infection in the first trimester were studied by Enzyme-linked immunoaborbed assay (ELISA) and polymerase chain reaction (PCR) with 49 cases of recurrent HCMV infection and 386 cases of previous HCMV infection in the second trimester or the third trimester serving as control. The primary infection rate was 4. 21%. In 20 cases of HCMV infection, their babies were diagnosed as congenital CMV infection. CMV-DNA was detected positive in amniofluid, cord blood, newborn external blood, urine or tissues of autopsy. The intrauterine transmission rate was 75.0 % (15/20). The rates of IUGR, stillbirth and congenital malformation were 20.0%, 5.0% and 10.0% respectively. The difference between primary infection group and recurrence infection group or previous infection group was statistically singnificant. The MDI (mental development index) of 10 babies of the mothers having primary CMV infection was lower than those of the other 13 babies of the mothers having recurrence CMV infection and 34 babies of the mothers having previous CMV infection and the difference was significant (P<0. 05). But the difference of PDI among three groups was n0t statistically singnificant (P >0. 05). The influence of primary CMV infection of pregnant women in the first trimester on their fetuses and infants was more severe than that of recurrent infection and previous infection. Serum screening for CMV-IgM, IgG of pregnant women was very important in the first trimester.