Cytomegalovirus infection in pregnancy.
OBJECTIVE
To investigate the effects of intrauterine human cytomegalovirus (HCMV) infection on pregnancy outcomes and infant development.


METHODS
The study group consisted of the HCMV-IgM-positive offspring of 75 pregnant women, and a control group of the non-infected offspring of 73 pregnant women. Chorionic villi, amnionic fluid, and umbilical blood were obtained to detect HCMV-late mRNA with a reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The pregnancy outcomes were followed up. For all offspring, neurological development was evaluated with neurosonography, audiologic development with the brainstem auditory evoked potential (BAEP), and psychomotor development with the Beyley Scale of Infant Development (BSID).


RESULTS
In the study group the positive rate of late mRNA was 50% in the chorionic villi and 67.65% in the amnionic fluid and the umbilical blood; the incidence of abnormal pregnancy outcomes (abortion, preterm delivery, stillbirth, etc.) was much higher than in the control group (40% vs. 6.57%; chi(2)=24.06; P=0.001); the abnormal rate of neurosonography results at birth and 3 months after birth was higher in the study group than in the control group (P<0.05), as were BAEP values 4 months after birth (chi(2)=8.960; P=0.003). Scores for the Infant Mental Development Index (MDI) were apparently lower than in the control group. When congenitally infected children were tested at the age of 5.5-6.5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), their rate of mental retardation was still found to be approximately 20%.


CONCLUSIONS
Intrauterine HCMV infection is closely related to abnormal pregnancy outcomes, infant neurological damage, mental retardation, and hearing loss.
Wen
L Z
LZ
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. cheny18@public.wh.hb.cn
Xing
W
W
Liu
L Q
LQ
Ao
L M
LM
Chen
S H
SH
Zeng
W J
WJ
D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D001927:Brain Diseases / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003586:Cytomegalovirus Infections / Q000635:transmission*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005333:Fetus / Q000002:abnormalities; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008607:Intellectual Disability / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D012333:RNA, Messenger / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014463:Ultrasonography
D012333:RNA, Messenger