Blood parameters in fetuses infected with cytomegalovirus according to the severity of brain damage and trimester of pregnancy at cordocentesis.
J Clin Virol
; 119: 37-43, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-31473566
ABSTRACT
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. STUDYDESIGN:
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; p0.03) and high levels of gamma-glutamyl transpeptidase (GGT) (≥151 IU/L; p0.02) 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), ß2 microglobulin >10.4â¯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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
/
Encéfalo
/
Infecções por Citomegalovirus
/
Citomegalovirus
/
Doenças Fetais
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article