Maternal immunoglobulin G avidity as a diagnostic tool to identify pregnant women at risk of congenital cytomegalovirus infection
| Autor: | Toshio Minematsu, Masanao Ohhashi, Junsuke Muraoka, Hiroshi Sameshima, Masatoki Kaneko, Kazumi Kusumoto |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Risk 0301 basic medicine Microbiology (medical) medicine.medical_specialty Antibody Affinity Congenital cytomegalovirus infection Cytomegalovirus Mothers Antibodies Viral Sensitivity and Specificity Immunoglobulin G Serology 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Pharmacology (medical) Avidity 030212 general & internal medicine Pregnancy Complications Infectious biology business.industry Obstetrics Infant Newborn medicine.disease 030104 developmental biology Infectious Diseases Immunoglobulin M Cytomegalovirus Infections Immunology biology.protein Gestation Female Antibody business |
| Zdroj: | Journal of Infection and Chemotherapy. 23:173-176 |
| ISSN: | 1341-321X |
| DOI: | 10.1016/j.jiac.2016.12.001 |
| Popis: | The immunoglobulin (Ig) G avidity index (AI) is useful to detect primary cytomegalovirus (CMV) infection. However, because IgG matures with time, this index is not useful to detect a primary infection, unless measured at an appropriate time.We aimed to clarify the difference between using IgG AI and IgM positivity according to the stage of pregnancy to identify congenital CMV infection risk.We collected the serum samples from 1115 pregnant women who underwent maternal screening for primary infection (n = 956) and were referred to our hospital because of CMV IgM positivity (n = 155) or had abnormal fetal ultrasonography findings (n = 4). The same sera samples were used to measure CMV IgM, IgG, and IgG AI. An IgG AI of35% was defined as low. Neonatal urine collected within 5 days after birth was examined by polymerase chain reaction to confirm congenital infection.Fourteen mothers gave birth to infected neonates. The sensitivity, specificity, and negative predictive values of the low IgG AI group with IgM-positive samples to discriminate between women with congenital infection at ≤14 weeks of gestation were 83.3, 83.8, and 99.1, respectively, which were higher than those of other subjects. Uni- and multivariate analyses revealed that IgM positivity and low IgG AI were independent variables associated with congenital infection at any stage of pregnancy, except low IgG AI at ≥15 weeks of gestation.Low IgG AI with IgM positivity at ≤14 weeks of gestation was a good indicator of congenital infection, which should prove useful in obstetric practice. |
| Databáze: | OpenAIRE |
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