51. Prospective Cohort Study of Congenital Cytomegalovirus Infection during Pregnancy with Fetal Growth Restriction: Serologic Analysis and Placental Pathology
- Author
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Mitsuru Tsuge, Akira I. Hida, Naotoshi Honda, Toshio Minematsu, Mikifumi Yokoyama, Yumi Oshiro, and Yoichi Kondo
- Subjects
Adult ,medicine.medical_specialty ,Urinary system ,Placenta ,Congenital cytomegalovirus infection ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Human placental lactogen ,Japan ,Pregnancy ,030225 pediatrics ,medicine ,Humans ,Serologic Tests ,030212 general & internal medicine ,Prospective Studies ,Pregnancy Complications, Infectious ,Prospective cohort study ,Inflammation ,Serum Amyloid A Protein ,Fetal Growth Retardation ,business.industry ,Obstetrics ,Body Weight ,Infant, Newborn ,virus diseases ,Fetal Body Weight ,medicine.disease ,Placental Lactogen ,medicine.anatomical_structure ,C-Reactive Protein ,Immunoglobulin G ,Pediatrics, Perinatology and Child Health ,Cytomegalovirus Infections ,DNA, Viral ,Female ,business ,beta 2-Microglobulin ,Biomarkers - Abstract
Objective To investigate prospectively the prevalence of congenital cytomegalovirus (CMV) infection and the pathologic features of the placenta in cases of fetal growth restriction (FGR). Study design Forty-eight pregnant women who were diagnosed with FGR during pregnancy were enrolled for 15 months. Maternal CMV serologic tests, pathologic examinations of the placenta, and newborn urinary CMV-DNA polymerase chain reaction tests were performed in all the cases. The clinical characteristics and laboratory findings of the pregnant women and their newborns were collected. Biomarkers for inflammation, angiogenesis, and placental hormones were measured in the maternal serum at FGR diagnosis or in the neonatal urine at birth. Results One of the 48 cases with FGR was a congenital CMV infection. CMV antigen was detected in the placenta of 7 cases with FGR. The change rate of the estimated fetal body weight was significantly lower in FGR cases with placental CMV detection. Placental villitis was observed more frequently in FGR cases with placental CMV detection. Human placental lactogen was significantly decreased in FGR cases with placental CMV detection. Increased C-reactive protein and serum amyloid A levels in the maternal serum were observed more frequently in FGR cases with placental CMV detection. Newborn urine β-2 microglobulin levels were significantly higher in FGR cases with placental CMV detection. Conclusions Serologic tests for maternal CMV, the change rate of the estimated fetal body weight, analysis of several biomarkers, and placental pathologic examinations might be helpful in comprehensively predicting the possibility of congenital CMV infection.
- Published
- 2018