巨细胞病毒（CMV）是妊娠期最常见的母婴垂直传播感染，也是可预防的儿童先天性残疾病因1。澳大利亚最新指南建议对高危孕妇进行早期CMV检测并提供卫生教育1。研究表明，这些干预措施能将CMV感染率从7.6%显著降低至1.6%，仅需向17名高危孕妇提供相关信息就可预防1例感染1。
对于早期妊娠初次感染的女性，抗病毒药物阿昔洛韦已被证实能有效降低病毒传播风险1。一项2020年随机对照试验显示，第一孕期初次感染的女性中，使用安慰剂组的病毒传播至胎儿率为48%，而接受阿昔洛韦治疗的女性该比例仅为11%1。
先天性CMV感染的危害严重1。约1/200新生儿出生时患有先天性CMV，可导致小头畸形、听力丧失、发育迟缓和脑瘫1。澳大利亚指南建议所有孕妇获得CMV信息和简单卫生预防措施指导，包括更换尿布后洗手、不与幼儿共用食物和餐具等1。目前阿昔洛韦在澳大利亚以非标签适应症方式提供，需进一步研究其对母婴长期结局的益处和风险1。2024年欧洲专家组建议对所有女性进行CMV检测，部分国家已开始实施全面筛查模式1。
Cytomegalovirus (CMV) represents the most common vertical transmission infection occurring during pregnancy and stands as a preventable cause of childhood disability.1 Approximately one in 200 newborns are born with congenital CMV, which can result in microcephaly, hearing loss, developmental delays, and cerebral palsy.1 Australia's updated guidelines now recommend early CMV testing for high-risk pregnant women combined with hygiene education to mitigate transmission risk.1
The evidence supporting these preventive measures is compelling. Early detection paired with targeted education has been shown to reduce CMV infection rates from 7.6% to 1.6%, requiring information provision to just 17 high-risk pregnant women to prevent a single infection case.1 All pregnant women should receive CMV information and guidance on straightforward hygiene precautions, including handwashing after diaper changes and avoiding sharing food and utensils with young children.1 For women experiencing primary infection during the first trimester, antiviral treatment offers substantial protection: a 2020 randomized controlled trial demonstrated that acyclovir reduced the rate of viral transmission to the fetus from 48% to 11% compared with placebo.1 Currently in Australia, acyclovir is provided off-label for this indication pending further research on its long-term benefits and risks for mother and baby.1 A 2024 European expert panel has recommended CMV testing for all women, with some countries now implementing comprehensive screening approaches.1
评论
还没有评论，欢迎留下第一条。