Perinatal Survival Following Parvovirus B19 Infection: Overall Outcomes and a Secondary Comparison of the 2023-2024 Outbreak to the Previous Two Decades.
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引用次数: 0
Abstract
Objectives: To evaluate perinatal survival following maternal parvovirus B19 virus (B19V) infection and compare the 2023-2024 outbreak to prior decades.
Method: A single tertiary center retrospective study (2005-2024) of all pregnancies with confirmed maternal B19V infection. Data on maternal, fetal, and neonatal outcomes were collected, with live birth rate as the primary outcome. Patients were divided into the 2023-2024 outbreak group and a control group (2005-2022) for comparison.
Results: Among 124 patients, 51 comprised the outbreak group and 73 comprised the control group. The live birth rate was 90.3%. Fetal hydrops (OR 18.0, 95% CI 2.12-153.03), intra-uterine transfusion (IUT) requirement (OR 1.33, 95% CI 1.09-1.69) and an earlier gestational age at first IUT (OR 0.6, 95% CI 0.37-0.96) were associated with decreased perinatal survival. The outbreak group presented earlier (15.5 [IQR 10.2-20.4] vs. 19.5 [IQR 15.0-23.0], p = 0.04), and had a higher fetal viral load (cycle threshold value 11.5 [IQR 7.54-13.57] vs. 16.63 [IQR 13.42-20.59], p = 0.01). However, rates of hydrops, indication for IUT, perinatal survival, abnormal CNS findings, and neonatal outcomes did not differ between the groups.
Conclusions: Fetal hydrops and an earlier indication for IUT were predictors of IUFD. Despite earlier presentation and higher viral load, the outbreak did not worsen perinatal outcomes.
目的：评估母体细小病毒B19病毒（B19V）感染后的围产期生存率，并将2023-2024年的爆发与前几十年进行比较。方法：采用单三级中心回顾性研究（2005-2024年），对所有确诊感染B19V的孕妇进行调查。收集了孕产妇、胎儿和新生儿结局的数据，以活产率为主要结局。将患者分为2023-2024年爆发组和对照组（2005-2022年）进行比较。结果：124例患者中，51例为暴发组，73例为对照组。活产率为90.3%。胎儿积水（OR 18.0, 95% CI 2.12-153.03）、子宫内输血（IUT）需求（OR 1.33, 95% CI 1.09-1.69）和首次IUT时胎龄较早（OR 0.6, 95% CI 0.37-0.96）与围产期生存率降低相关。爆发组出现较早（15.5 [IQR 10.2-20.4] vs. 19.5 [IQR 15.0-23.0], p = 0.04），胎儿病毒载量较高（周期阈值11.5 [IQR 7.54-13.57] vs. 16.63 [IQR 13.42-20.59], p = 0.01）。然而，水肿率、IUT指征、围产期生存率、中枢神经系统异常发现和新生儿结局在两组之间没有差异。结论：胎儿积液和早期IUT指征是IUFD的预测因素。尽管出现时间较早，病毒载量较高，但疫情并未恶化围产期结局。
期刊介绍：
Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling
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