[The epidemiological study on human cytomegalovirus infection of pregnant women and the maternal-fetal transmission in three Chinese metropolis]

Abstract

Objectives: To analyze the state of human cytomegalovirus (HCMV) infection of pregnant women and the maternal-fetal transmission in three chinese metropolis, and to study the methods of early prenatal diagnosis for intrauterine infection.

Methods: Enzyme linked immunosorbent assay (ELISA) technique was employed to screen HCMV specific antibodies in 5,015 pregnant women of different trimesters. From this cohort study, 301 cases of active infection were selected to detect HCMV DNA by polymerase chain reaction (PCR) technique in their appendages of fetus, blood and urine of neonates, as well as breast milk.

Results: The overall HCMV infection rate was 88.93% in the three metropolis and they were 96.74% and 91.42% in Shenyang and Shanghai respectively, which were significantly higher than that (79.53%) in Wuhan. The active infection rate was 5.42% generally while they were 11.23% and 10.89% in Wuhan and Shenyang respectively, which were significantly higher than that in Shanghai. In addition, the active infection rate of women with history of abnormal pregnancy was significantly higher than that was of the control group (14.59% vs 3.70%). By PCR technique, the detective rate of HCMV DNA were 16.00% in chroionic villi of early pregnancy and 35.33% in amniotic fluid of mid-trimester, which were not significantly different from these in umbilical blood, placentea at delivery and neonatal blood.

Conclusions: In China, the HCMV infection rates during pregnancy varied in different regions. A majority of women at children bearing age had HCMV infection before pregnancies; the yertical transmission frequently occurs from the actively infected mother. ELISA combined with PCR techniques is a valuable method for early prenatal diagnosis of HCMV congenital infection.