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1.
PLoS One ; 14(3): e0212784, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30893310

RESUMO

BACKGROUND: International guidelines lack a substantial consensus regarding management of asymptomatic full-term and late preterm neonates at risk for early-onset disease (EOS). Large cohorts of newborns are suitable to increase the understanding of the safety and efficacy of a given strategy. METHODS: This is a prospective, area-based, cohort study involving regional birth facilities of Emilia-Romagna (Italy). We compared cases of EOS (at or above 35 weeks' gestation) registered in 2003-2009 (baseline period: 266,646 LBs) and in 2010-2016, after introduction of a new strategy (serial physical examinations, SPEs) for managing asymptomatic neonates at risk for EOS (intervention period: 265,508 LBs). RESULTS: There were 108 cases of EOS (baseline period, n = 60; intervention period, n = 48). Twenty-two (20.4%) remained asymptomatic through the first 72 hours of life, whereas 86 (79.6%) developed symptoms, in most cases (52/86, 60.5%) at birth or within 6 hours. The median age at presentation was significantly earlier in the intrapartum antibiotic prophylaxis (IAP)-exposed than in the IAP-unexposed neonates (0 hours, IQR 0.0000-0.0000 vs 6 hours, IQR 0.0000-15.0000, p<0.001). High number of neonates (n = 531) asymptomatic at birth, exposed to intrapartum fever, should be treated empirically for each newborn who subsequently develops sepsis. IAP exposed neonates increased (12% vs 33%, p = 0.01), age at presentation decreased (median 6 vs 1 hours, p = 0.01), whereas meningitis, mechanical ventilation and mortality did not change in baseline vs intervention period. After implementing the SPEs, no cases had adverse outcomes due to the strategy, and no cases developed severe disease after 6 hours of life. CONCLUSIONS: Infants with EOS exposed to IAP developed symptoms at birth in almost all cases, and those who appeared well at birth had a very low chance of having EOS. The risk of EOS in neonates (asymptomatic at birth) exposed to intrapartum fever was low. Although definite conclusions on causation are lacking, our data support SPEs of asymptomatic newborns at risk for EOS. SPEs seems a safe and effective alternative to laboratory screening and empirical antibiotic therapy.

3.
J Pediatr ; 197: 320, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29551317
4.
Fetal Diagn Ther ; 43(2): 138-142, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28697499

RESUMO

OBJECTIVE: To evaluate perinatal outcomes in case of non-primary maternal cytomegalovirus (CMV) infection. METHODS: We performed a retrospective cohort study of pregnant women with active CMV infection referred to our unit over a 15-year period (January 2000 to December 2014). Non-primary infection was diagnosed on the basis of the results of confirmatory serological and virological tests (avidity test, immunoblotting, real-time PCR-DNA). The vertical transmission rate and the percentage of symptomatic congenital infection were determined in this group of patients. RESULTS: A total of 205 pregnant women were enrolled. Congenital infection occurred in 7 (3.4%) fetuses/neonates. Symptomatic disease was present at birth in 3 of the 7 congenitally infected neonates (1.5%). Two out of 3 symptomatic newborns presented a pathologic second-trimester ultrasound scan. CONCLUSION: Maternal immunity offers substantial protection against intrauterine transmission of CMV infection, but not against disease once the fetus is infected.


Assuntos
Infecções por Citomegalovirus/diagnóstico por imagem , Citomegalovirus , Transmissão Vertical de Doença Infecciosa , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Ultrassonografia Pré-Natal/tendências , Estudos de Coortes , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/epidemiologia , Feminino , Seguimentos , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
5.
J Pediatr ; 191: 262-265.e2, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29173315

RESUMO

Skin disinfection with chlorhexidine gluconate has not been standardized in preterm infants. We present 5 cases of chemical burns that occurred within the first 2 days of life in very low birth weight neonates after skin disinfection with aqueous and alcohol-based chlorhexidine solutions.


Assuntos
Anti-Infecciosos Locais/efeitos adversos , Queimaduras Químicas/etiologia , Clorexidina/análogos & derivados , Recém-Nascido de muito Baixo Peso , Queimaduras Químicas/diagnóstico , Clorexidina/efeitos adversos , Humanos , Recém-Nascido , Recém-Nascido Prematuro
7.
J Clin Virol ; 97: 59-63, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29149633

RESUMO

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is responsible of a high burden of neurosensory impairment in children. OBJECTIVES: To report incidence and consequences of ophthalmological abnormalities in infants with cCMV infection and better define their long-term ophthalmological management. STUDY DESIGN: Infants with cCMV infection were enrolled in a 6-year follow-up. Infants were classified as symptomatic or asymptomatic based on complete clinical, laboratory and instrumental evaluations. All infants underwent funduscopic evaluation in neonatal period, and yearly complete ophthalmological evaluation, including funduscopic, motility and visual acuity assessments. RESULTS: Forty-eight infants were enrolled, 18/48 (37.5%) symptomatic and 30/48 (62.5%) asymptomatic. Mean duration of follow-up was 34.9±22.2 vs. 34.8±20.1months (P=0.98). Funduscopic abnormalities were identified in neonatal period in 7/18 (39%) symptomatic infants and in none of the infants without other clinical and instrumental abnormalities at birth (P<0.001); chorioretinal scars were the most common finding (5/18 cases, 28%). Strabismus was detected in 1/18 (5.5%) symptomatic infants during the first years of life. Visual impairment at last follow-up evaluation was suspected or detected in 4/18 (22%) symptomatic infants and in none of the asymptomatic infants at birth (P=0.01). Ophthalmological abnormalities were associated with other signs of central nervous system (CNS) involvement (P<0.001). No correlation was found with the type of maternal infection. CONCLUSIONS: Ophthalmological abnormalities were common in symptomatic infants though often not associated with long-term visual impairment, and correlated with the presence of CNS involvement. Neonatal and periodical ophthalmological evaluations throughout childhood seem prudential for symptomatic babies. No ophthalmological abnormalities were detected in asymptomatic infants, who might therefore undergo more deferred evaluations.


Assuntos
Infecções Assintomáticas/epidemiologia , Coriorretinite/virologia , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/complicações , Anormalidades do Olho/virologia , Sistema Nervoso Central/virologia , Pré-Escolar , Coriorretinite/complicações , Coriorretinite/diagnóstico , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/virologia , Anormalidades do Olho/complicações , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Itália/epidemiologia , Masculino , Fatores de Tempo , Visão Ocular , Acuidade Visual
8.
J Virol Methods ; 248: 250-254, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28801056

RESUMO

Clinical evaluation of the Elecsys® CMV IgM, IgG, IgG Avidity and COBAS AmpliPrep/COBAS TaqMan CMV (COBAS CMV) assays (Roche Diagnostics AG) in the diagnosis and prognosis of congenital CMV infection was performed. In this study, 150 preselected clinical samples (50 primary infection sera, 50 amniotic fluid [AF] and 50 newborn urine) were processed using Roche serological/molecular CMV-specific tests. Results were compared with those obtained by routine assays (comparator assays). The Elecsys® CMV IgM and IgG assays showed a perfect agreement (100%) with the comparator assays. Using the combination of the Elecsys® CMV IgM and IgG Avidity assays results, a primary infection was identified in 100% of cases. Inappropriate avidity CMV IgG values in two samples with very low IgG values (<6 AU/mL) were observed. COBAS CMV assay showed an agreement equal to 98% and 100% with comparator assays by processing AF and urine samples, respectively. Among AF with quantitative results, Lin's concordance correlation was 0.933 and comparator-COBAS CMV assays gave CMV-DNA loads differing by <0.5 log10 DNA. Finally, higher CMV-DNA levels in AF samples were associated with a symptomatic outcome (p=0.003). The Roche CMV-specific assays compared well with the comparator assays, thus providing to be suitable for clinical use.


Assuntos
Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/diagnóstico , Citomegalovirus/isolamento & purificação , Técnicas de Diagnóstico Molecular/métodos , Testes Sorológicos , Anticorpos Antivirais/sangue , Afinidade de Anticorpos , Técnicas de Laboratório Clínico/métodos , Citomegalovirus/genética , Citomegalovirus/imunologia , Infecções por Citomegalovirus/imunologia , Infecções por Citomegalovirus/virologia , DNA Viral/análise , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Técnicas de Diagnóstico Molecular/instrumentação , Gravidez , Prognóstico , Kit de Reagentes para Diagnóstico , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
J Matern Fetal Neonatal Med ; 30(14): 1739-1744, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27593156

RESUMO

INTRODUCTION: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking. MATERIALS AND METHODS: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated. RESULTS: Among 7133 women, 259 (3.6%) were preterm (35-36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1 RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive. IAP was given to 2369 (33.2%) women (preterm, n = 166; full term, n = 2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p < 0.01). Full-term women represented the largest area under the curve (AUC, 0.87). PROM showed the highest sensitivity (98.6%), but the lowest specificity (6.9%) and AUC (0.53). CONCLUSIONS: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM.


Assuntos
Ampicilina/administração & dosagem , Antibacterianos/administração & dosagem , Antibioticoprofilaxia/estatística & dados numéricos , Assistência Perinatal/estatística & dados numéricos , Infecções Estreptocócicas/prevenção & controle , Feminino , Fidelidade a Diretrizes , Humanos , Transmissão Vertical de Doença Infecciosa , Gravidez , Nascimento Prematuro , Reto/microbiologia , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/congênito , Infecções Estreptocócicas/transmissão , Vagina/microbiologia
12.
J Immunol Res ; 2016: 3890306, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27699182

RESUMO

Human leukocyte antigen-G (HLA-G) is a nonclassical HLA class I antigen that is expressed during pregnancy contributing to maternal-fetal tolerance. HLA-G can be expressed as membrane-bound and soluble forms. HLA-G expression increases strongly during viral infections such as congenital human cytomegalovirus (HCMV) infections, with functional consequences in immunoregulation. In this work we investigated the expression of soluble (s)HLA-G and beta-2 microglobulin (component of HLA) molecules in correlation with the risk of transmission and severity of congenital HCMV infection. We analyzed 182 blood samples from 130 pregnant women and 52 nonpregnant women and 56 amniotic fluid samples from women experiencing primary HCMV infection. The median levels of sHLA-G in maternal serum of women with primary HCMV infection were higher in comparison with nonprimary and uninfected pregnant women (p < 0.001). AF from HCMV symptomatic fetuses presented higher sHLA-G levels in comparison with infected asymptomatic fetuses (p < 0.001), presence of HLA-G free-heavy chain, and a concentration gradient from amniotic fluid to maternal blood. No significant statistical difference of beta-2 microglobulin median levels was observed between all different groups. Our results suggest the determination of sHLA-G molecules in both maternal blood and amniotic fluid as a promising biomarker of diagnosis of maternal HCMV primary infection and fetal HCMV disease.


Assuntos
Líquido Amniótico/imunologia , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/imunologia , Feto/imunologia , Antígenos HLA-G/sangue , Complicações Infecciosas na Gravidez/imunologia , Adolescente , Adulto , Líquido Amniótico/química , Líquido Amniótico/virologia , Anticorpos Antivirais/sangue , Biomarcadores/sangue , Citomegalovirus/imunologia , Infecções por Citomegalovirus/diagnóstico , Feminino , Idade Gestacional , Antígenos HLA-G/genética , Antígenos HLA-G/imunologia , Humanos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Adulto Jovem , Microglobulina beta-2/sangue , Microglobulina beta-2/genética
13.
New Microbiol ; 39(4): 314-316, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27284987

RESUMO

Prophylaxis with zidovudine and 3 doses of nevirapine (NVP) is recommended for infants born to HIV-1 infected untreated mothers to prevent HIV-1 mother-to-child transmission. However little is known about NVP pharmacokinetics in neonates, mostly in preterm infants. We performed therapeutic monitoring of NVP plasma concentrations in a 32-week preterm HIV-1 exposed infant born to an infected untreated mother. With the recommended regimen, an intense NVP exposure was observed, with NVP plasma levels exceeding the target concentration by up to 40 times, suggesting that when a laboratory assessment of NVP plasma concentrations is available, it may be useful to monitor and optimize drug exposure.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Nevirapina/farmacocinética , Nevirapina/uso terapêutico , Fármacos Anti-HIV/farmacocinética , Fármacos Anti-HIV/uso terapêutico , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Oligopeptídeos/uso terapêutico , Gravidez , RNA Viral
14.
Clin Vaccine Immunol ; 23(5): 410-416, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26961856

RESUMO

Serology has a pivotal role in the diagnosis of congenital syphilis (CS), but problems arise because of the passive transfer of IgG antibodies across the placenta. The aim of this study was to assess the diagnostic value of a comparative Western blot (WB) method finalized to match the IgG immunological profiles of mothers and their own babies at birth in order to differentiate between passively transmitted maternal antibodies and antibodies synthesized by the infants against Treponema pallidum Thirty infants born to mothers with unknown or inadequate treatment for syphilis were entered in a retrospective study, conducted at St. Orsola-Malpighi Hospital, Bologna, Italy. All of the infants underwent clinical, instrumental, and laboratory examinations, including IgM WB testing. For the retrospective study, an IgG WB assay was performed by blotting T. pallidum antigens onto nitrocellulose sheets and incubating the strips with serum specimens from mother-child pairs. CS was diagnosed in 11 out of the 30 enrolled infants; 9/11 cases received the definitive diagnosis within the first week of life, whereas the remaining two were diagnosed later because of increasing serological test titers. The use of the comparative IgG WB testing performed with serum samples from mother-child pairs allowed a correct CS diagnosis in 10/11 cases. The CS diagnosis was improved by a strategy combining comparative IgG WB results with IgM WB results, leading to a sensitivity of 100%. The comparative IgG WB test is thus a welcome addition to the conventional laboratory methods used for CS diagnosis, allowing identification and adequate treatment of infected infants and avoiding unnecessary therapy of uninfected newborns.


Assuntos
Anticorpos Antibacterianos/sangue , Western Blotting/métodos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Sífilis Congênita/sangue , Sífilis Congênita/diagnóstico , Treponema pallidum/imunologia , Western Blotting/instrumentação , Colódio , Diagnóstico Precoce , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Itália , Mães , Cuidado Pós-Natal , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade , Sífilis Congênita/imunologia , Sífilis Congênita/microbiologia
15.
J Immunol Res ; 2016: 8374328, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28070527

RESUMO

Background. The neonatal immune system is not fully developed at birth; newborns have adequate lymphocytes counts but these cells lack function. Objective. To assess the activity of T-cells and the influence of the main perinatal factors in very preterm infants (birth weight < 1500 g). Design. Blood samples from 59 preterm infants (21/59 were dizygotic twins) were collected at birth and at 30 days of life to measure CD4+ T-cell activity using the ImmuKnow™ assay. Fifteen healthy adults were included as a control group. Results. CD4+ T-cell activity was lower in VLBW infants compared with adults (p < 0.001). Twins showed lower immune activity compared to singletons (p = 0.005). Infants born vaginally showed higher CD4+ T-cell activity compared to those born by C-section (p = 0.031); infants born after prolonged Premature Rupture of Membranes (pPROM) showed higher CD4+ T-cell activity at birth (p = 0.002) compared to infants born without pPROM. Low CD4+ T-cell activity at birth is associated with necrotizing enterocolitis (NEC) in the first week of life (p = 0.049). Conclusions. Preterm infants show a lack in CD4+ T-cell activity at birth. Perinatal factors such as intrauterine inflammation, mode of delivery, and zygosity can influence the adaptive immune activation capacity at birth and can contribute to exposing these infants to serious complications such as NEC.


Assuntos
Imunidade Adaptativa/imunologia , Trifosfato de Adenosina/biossíntese , Linfócitos T CD4-Positivos/imunologia , Sistema Imunitário/embriologia , Lactente Extremamente Prematuro/imunologia , Adulto , Enterocolite Necrosante/imunologia , Humanos , Lactente Extremamente Prematuro/sangue , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Estudos Longitudinais , Ativação Linfocitária/imunologia , Estudos Prospectivos , Sepse/imunologia
16.
J Matern Fetal Neonatal Med ; 29(19): 3126-31, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26515917

RESUMO

OBJECTIVE: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS. METHODS: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed. RESULTS: Live births (LB) numbered 146 682. Ninety neonates had EOS and 12 died (incidence rates of 0.61 and 0.08/1000 LB, respectively). EOS and mortality were the highest among neonates with a birth weight <1000 g (20.37/1000 LB and 8.49/1000 LB, respectively). The most common pathogens were GBS (n = 27, 0.18/1000 LB) and Escherichia coli (n = 19, 0.13/1000 LB). Most infants affected by E. coli EOS were born preterm (n = 13), had complications (n = 4) or died (n = 7). Among 90 isolates tested, only 3 were resistant to both first line empirical antibiotics. Multivariate logistic regression analysis showed that low gestational age, caesarean section and low platelet count at presentation were significantly associated with death or brain lesions (area under ROC curve = 0.939, H-L = 0.944, sensitivity 76.0%, specificity 90.7%). CONCLUSIONS: GBS slightly exceeds E. coli as a cause of EOS. However, E. coli is the prominent cause of death, complications and in most cases affects preterm neonates. Empirical antimicrobial therapy of EOS seems appropriate.

17.
J Immunol Res ; 2014: 850831, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25089282

RESUMO

Primary immunodeficiencies are rare inherited disorders that may lead to frequent and often severe acute respiratory infections. Respiratory syncytial virus (RSV) is one of the most frequent pathogens during early infancy and the infection is more severe in immunocompromised infants than in healthy infants, as a result of impaired T- and B-cell immune response unable to efficaciously neutralize viral replication, with subsequent increased viral shedding and potentially lethal lower respiratory tract infection. Several authors have reported a severe clinical course after RSV infections in infants and children with primary and acquired immunodeficiencies. Environmental prophylaxis is essential in order to reduce the infection during the epidemic season in hospitalized immunocompromised infants. Prophylaxis with palivizumab, a humanized monoclonal antibody against the RSV F protein, is currently recommended in high-risk infants born prematurely, with chronic lung disease or congenital heart disease. Currently however the prophylaxis is not routinely recommended in infants with primary immunodeficiency, although some authors propose the extension of prophylaxis to this high risk population.


Assuntos
Síndromes de Imunodeficiência/complicações , Infecções por Vírus Respiratório Sincicial/complicações , Infecções por Vírus Respiratório Sincicial/imunologia , Vírus Sincicial Respiratório Humano/imunologia , Antivirais/uso terapêutico , Quimioprevenção , Humanos , Hospedeiro Imunocomprometido , Lactente , Recém-Nascido , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/prevenção & controle
18.
J Pediatr ; 165(6): 1255-7, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25171852

RESUMO

We evaluated the effects of bolus vs continuous tube feeding on cardiorespiratory events, detected by polysomnographic monitoring, in healthy preterm infants. Continuous tube feeding resulted in a significant increase of apneas and apneas-related hypoxic episodes compared with bolus feeding.


Assuntos
Apneia/epidemiologia , Bradicardia/epidemiologia , Nutrição Enteral/métodos , Hipóxia/epidemiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Polissonografia
19.
J Clin Microbiol ; 52(8): 2963-70, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24899036

RESUMO

The aim of this study was to assess the diagnostic value of IgM Western blotting (WB), IgA enzyme immunoassay (EIA), and DNA amplification by real-time PCR on Guthrie cards to retrospectively establish the diagnosis of congenital toxoplasmosis (CT). To this purpose, Guthrie cards were collected from 18 infants born to mothers with primary Toxoplasma gondii infection during pregnancy. Moreover, the analytical sensitivity of T. gondii PCR was assessed by testing mock dried blood specimens set up with several known DNA dilutions. IgM WB was demonstrated to be the most sensitive method. When the results of T. gondii DNA detection and specific IgM recovery were combined, retrospective CT diagnosis by using Guthrie cards was established in 3 out of 6 infected infants (sensitivity, 50%; 95% confidence interval, 26.8% to 73.2%). No positive PCR or serologic results were found in the group of 12 uninfected infants, demonstrating the excellent specificity of the three methods (95% confidence interval, 78.1% to 99.5%). The findings of the present study suggest that, in cases of missed diagnosis of CT at birth, analysis of Guthrie cards for children with compatible clinical findings after the perinatal period, in particular the combination of recovery of specific IgM antibodies and T. gondii DNA amplification, could be helpful. Nevertheless, since suboptimal conditions of storage of dried blood specimens can seriously affect sensitivity, negative results cannot rule out CT diagnosis. In contrast, because of the excellent specificity shown by IgM serologic testing and T. gondii DNA amplification on Guthrie cards, positive results obtained by either of the two methods should be considered diagnostic.


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Toxoplasma/isolamento & purificação , Toxoplasmose Congênita/diagnóstico , Anticorpos Antiprotozoários/análise , Western Blotting , DNA de Protozoário/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase , Gravidez , Sensibilidade e Especificidade , Testes Sorológicos , Toxoplasmose Congênita/parasitologia
20.
Prenat Diagn ; 34(8): 765-9, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24665022

RESUMO

OBJECTIVE: To evaluate the incidence of infants with birth weight less than the 10(th) centile for small for gestational age (SGA) in primary maternal cytomegalovirus (CMV) infection and to determine whether SGA predicts poor neurodevelopmental outcome. METHODS: A retrospective cohort study, which included singleton live-born infants from pregnancies complicated by primary maternal CMV infection. Infants were classified as uninfected or infected based on viral virus isolation and real-time PCR in urine at birth. SGA neonates rate and long-term sequelae were evaluated. RESULTS: Between 2000 and 2012, 848 women with primary CMV infection were referred to our center with 588 infants assessed at birth. Congenital CMV infection was diagnosed in 119 cases (20%), of which 8 were SGA (6.7%) compared with 27 out of the 469 uninfected infants (5.7%) (p-value = 0.69). Among the 119 infected babies, 14 infants were symptomatic at birth or at postnatal follow-up (12%), of whom two were SGA compared with six out of the 105 asymptomatic neonates (5.7% versus 15%, respectively, p-value = 0.22). CONCLUSION: Congenital CMV infection does not seem to be associated with a higher incidence of SGA, and long-term outcomes do not seem to be affected by isolated impaired fetal growth.


Assuntos
Infecções por Citomegalovirus/congênito , Recém-Nascido Pequeno para a Idade Gestacional , Adulto , Infecções por Citomegalovirus/complicações , Deficiências do Desenvolvimento/etiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos
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