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中国循证儿科杂志

中国循证儿科杂志 ›› 2015, Vol. 10 ›› Issue (6): 434-437.

• 论著 • 上一篇    下一篇

上海市三级和一级医院新生儿先天性巨细胞病毒感染横断面调查

叶丽静1,董妞妞2,叶颖子1,徐锦2,俞蕙1   

  1. 复旦大学附属儿科医院 1 感染科，2  感染传染病实验室 上海，201102
  • 收稿日期:2015-06-19 修回日期:2015-12-24 出版日期:2015-12-05 发布日期:2015-12-04
  • 通讯作者: 俞蕙,徐锦

Cross-sectional study on newborn congenital cytomegalovirus infection in a tertiary special hospital and a community hospital in Shanghai

YE Li-jing1, DONG Niu-niu2, YE Ying-zi1, XU Jin2, YU Hui1   

  1. 1 Department of Infectious Diseases, 2 Laboratory of Infectious Diseases, Children's Hospital of Fudan University; Shanghai 201102, China
  • Received:2015-06-19 Revised:2015-12-24 Online:2015-12-05 Published:2015-12-04
  • Contact: YU Hui, XU Jin

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摘要：

目的 通过上海市区的三级甲等医院和相对远离上海市区的一级医院先天性巨细胞病毒（CMV）检测，反映上海地区先天性CMV感染情况。方法 收集复旦大学附属妇产科医院（简称复旦妇产医院）和上海闵行区浦江镇社区卫生服务中心（简称浦江医院）出生时活产的、并行新生儿疾病筛查的新生儿，利用新生儿疾病筛查后余下的干血斑点（DBS）标本以荧光定量PCR方法检测CMV DNA载量，根据新生儿疾病筛查信息和电话随访分析先天性CMV感染危险因素。危险因素定义如下：性别；出生胎龄（胎龄＜37周、～42周和≥42周）；出生体重（＜2 500 g、～3 999 g和≥4 000 g）；母亲分娩年龄（25~30岁、>30岁第1胎或≥35岁）；户籍（上海和非上海市户籍）；教育程度（初中及以下、高中、大学及以上）；家庭人口数（≤3口人、4口人、>5口人）。结果 2011年9月至2013年3月1 780份DBS标本用于CMV感染率的分析，其中浦江医院942份，复旦妇产医院838份，两医院先天性CMV总感染率为0.9%（17/1 780），其中浦江医院感染率为1.6%（15/942），复旦妇产医院感染率为0.2%（2/838），差异有统计学意义（P=0.003 4）。共收集到1 530例新生儿及母亲临床资料的电话随访数据，CMV阳性和阴性新生儿母亲文化程度差异有统计学意义(P=0.008 5)，其他危险因素两组间差异均无统计学意义。结论 上海地区先天性CMV感染率为0.9%，与性别、胎龄、出生体重及母亲户籍、家庭人口数不相关，与母亲教育程度相关。

Abstract:

Objective To estimate the prevalence of congenital cytomegalovirus (CMV) in Shanghai by analyzing the situation of congenital cytomegalovirus infection in newborns. Methods Relevant data of the live births were collected, who were systematically screened for neonatal diseases by using dry blood spot (DBS) samples derived from heel picking in the Affiliated Obstetrics and Gynecology Hospital of Fudan University, referred to as the Maternity Hospital of Fudan University, and in Pujiang Town Community Health Center Hospital in Minhang District, Shanghai, called Pujiang Hospital for short. CMV DNA loading in the rest of DBS after the neonatal diseases screening, was detected by fluorescence quantitative PCR. Risk factors of congenital CMV infection were analyzed according to the neonatal medical records and telephone follow-up. The risk factors included the following definitions: ① Neonatal sex; ② Gestational age (＜37 weeks, ～42 weeks, ≥42 weeks) ; ③ Birth weight (＜2 500 g, ～3 999 g, ≥4 000 g) ; ④ Maternal age( 25-29 years old, first births >30 years old or ≥35 years old)；⑤ Native place(Shanghai, Non Shanghai)；⑥ Mothers' educational status (junior school degree or below, high school, university degree or above); ⑥ Current family population(≤3 family members, 4 family members,>5 family members). Results ① Among 1 780 DBS of newborn screening collected from neonatal heel peripheral blood within 3 days from September 2011 to March 2013, 942 of which were from the Pujiang Hospital and the rest were from the Maternity Hospital of Fudan University. The congenital CMV infection rate of the two hospitals was 0.9%(17/1 780). 1.6% (15/942) for the former and 0.2% (2/838) for the latter, with significant difference between the two groups (P=0.003 4). ②1 530 neonatal and mothers' medical records and telephone follow-ups were collected. There was a significant difference in mothers' education levels between the CMV positive and negative groups (P=0.008 5), but the difference of other risk factors had no statistical significance. Conclusion The congenital CMV infection rate was 0.9% in Shanghai. There was no obvious correlation between congenital CMV infection rates and the neonatal sex, gestational age, birth weight, mothers' native place and family size. There was statistically significance in mothers' educational status between the negative and positive groups.