Blood parameters in fetuses infected with cytomegalovirus according to the severity of brain damage and trimester of pregnancy at cordocentesis
| Autor: | Elisenda Eixarch, Marta López, Laura García-Otero, Francesc Figueras, Anna Goncé, Laura Salazar, Ameth Hawkins-Villarreal, M Angeles Marcos, Raigam Jafet Martinez-Portilla, Ana L. Moreno-Espinosa, Antoni Borrell |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology Congenital cytomegalovirus infection Cytomegalovirus Gestational Age Brain damage Logistic regression Sensitivity and Specificity Gastroenterology 03 medical and health sciences 0302 clinical medicine Pregnancy Virology Internal medicine medicine Humans 030212 general & internal medicine Pregnancy Complications Infectious Fetus Receiver operating characteristic Beta-2 microglobulin business.industry Brain Gestational age Fetal Blood Prognosis medicine.disease Fetal Diseases Infectious Diseases Cytomegalovirus Infections DNA Viral Female medicine.symptom Cordocentesis business |
| Zdroj: | Journal of Clinical Virology. 119:37-43 |
| ISSN: | 1386-6532 |
| DOI: | 10.1016/j.jcv.2019.08.008 |
| Popis: | Background and objective Cytomegalovirus (CMV) remains a major cause of congenital infection and disease. During pregnancy, symptomatic cases can be detected through ultrasound (US) features, nevertheless, prognostic assessment is difficult. The aim of this study was to assess the predictive value of specific blood parameters in CMV infected fetuses. Study design Twenty-eight CMV-infected fetuses in which a cordocentesis had been performed were included. Fetuses were considered severely or mildly affected according to prenatal US/MRI brain damage. Fetal blood parameters were assessed for the prediction of severe brain abnormalities, and compared according to the trimester of pregnancy. Logistic regression and receiver operating curve analysis were performed. Results Thrombocytopenia (≤100,000/mm3; p:0.03) and high levels of gamma-glutamyl transpeptidase (GGT) (≥151 IU/L; p:0.02) signaled severity. For the prediction of brain damage, GGT levels ≥ 183 UI/l achieved 71% sensitivity, 83% specificity (AUC: 0.78), and OR of 2.05 (95% CI: 1.22–3.43) per 100 IU/l increase, adjusted for gestational age. However, thrombocytopenia (91% vs 50%; p: 0.04), β2 microglobulin >10.4 mg/l (60% vs 0% p: 0.03), CMV-DNA >50,000 copies/ml (80% vs 25%; p: 0.02), and positive IgM (70% vs 17%; p: 0.04) were observed significantly more often in severely damaged fetuses sampled ≤28 weeks than thereafter. Conclusion In CMV infected fetuses, thrombocytopenia and high levels of GGT are associated with severe US/MRI brain abnormalities. Nevertheless, among severely affected fetuses, blood parameters, with exception of GGT, change according to gestational age. Fetal blood could be less predictive of brain damage in the third trimester. |
| Databáze: | OpenAIRE |
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