{"title":"细小病毒B19感染后的围产期生存：2023-2024年爆发与前二十年的总体结果和二次比较","authors":"Noam Regev, Noam Pardo, Michal Axelrod, Chen Berkovitz, Eliel Klapholz, Orna Mor, Hagai Avnet, Boaz Weisz, Shali Mazaki-Tovi, Yoav Yinon","doi":"10.1002/pd.6860","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate perinatal survival following maternal parvovirus B19 virus (B19V) infection and compare the 2023-2024 outbreak to prior decades.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":20387,"journal":{"name":"Prenatal Diagnosis","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perinatal Survival Following Parvovirus B19 Infection: Overall Outcomes and a Secondary Comparison of the 2023-2024 Outbreak to the Previous Two Decades.\",\"authors\":\"Noam Regev, Noam Pardo, Michal Axelrod, Chen Berkovitz, Eliel Klapholz, Orna Mor, Hagai Avnet, Boaz Weisz, Shali Mazaki-Tovi, Yoav Yinon\",\"doi\":\"10.1002/pd.6860\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate perinatal survival following maternal parvovirus B19 virus (B19V) infection and compare the 2023-2024 outbreak to prior decades.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":20387,\"journal\":{\"name\":\"Prenatal Diagnosis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Prenatal Diagnosis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/pd.6860\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GENETICS & HEREDITY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prenatal Diagnosis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pd.6860","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
引用次数: 0
摘要
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。
Perinatal Survival Following Parvovirus B19 Infection: Overall Outcomes and a Secondary Comparison of the 2023-2024 Outbreak to the Previous Two Decades.
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.
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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