ABSTRACT

Objective: To examine the safety and efficacy of hyeprimmunoglobulin therapy on vertical transmission of congenital cytomegalovirus (CCMV).

Method: We searched nine databases for studies investigating the effect of Hyperimmunoglobulin among pregnant women with CMV.

Results: Of total eight studies, the pooled prevalence of CCMV was 36.5% (95% confidence intervals (CI): 26–49%). There was no evidence that hyperimmunoglobulin is effective against CCMV [odds ratio (OR) (95% (CI)) = 0.53 (0.20–1.42)]. However, analyzing only studies of pregnant women with confirmed primary infection, a significant reduction in the congenital CCMV rates was observed [OR (95% CI) = 0.33 (0.18–0.59)]. Based on the purpose, CCMV prevention was successful with a reduction of the CCMV rates [OR (95% CI) = 0.33 (0.16–0.68)[, while treatment was not]OR (95% CI) = 0.80 (0.04–15.01)]. The most common adverse pregnancy outcome was prematurity, followed by intrauterine growth retardation (IUGR) and termination of pregnancy (TOP), with no significant impact of antenatal hyperimmunoglobulin usage.

Conclusion: Our results showed a promising efficacy of hyperimmunoglobulin therapy among pregnant women with confirmed primary infection, which fades away on including secondary infection. This effectiveness was limited to the prevention, not the treatment, of CCMV. More randomized controlled trials are needed to provide concrete evidence.

摘要

目的：探讨乙肝免疫球蛋白治疗先天性巨细胞病毒（CCMV）垂直传播的安全性和有效性。

方法：我们在九个数据库中搜索了研究高免疫球蛋白对 CMV 孕妇的影响的研究。

结果：在总共八项研究中，CCMV 的汇总流行率为 36.5%（95% 置信区间 (CI)：26-49%）。没有证据表明高免疫球蛋白对 CCMV 有效 [比值比 (OR) (95% (CI)) = 0.53 (0.20–1.42)]。然而，仅分析确诊为原发性感染的孕妇的研究，观察到先天性 CCMV 发生率显着降低 [OR (95% CI) = 0.33 (0.18–0.59)]。基于此目的，CCMV 预防成功，CCMV 发生率降低 [OR (95% CI) = 0.33 (0.16–0.68)[，而治疗不是] OR (95% CI) = 0.80 (0.04–15.01) ]。最常见的不良妊娠结局是早产，其次是宫内发育迟缓 (IUGR) 和终止妊娠 (TOP)，产前高免疫球蛋白的使用没有显着影响。

结论：我们的结果表明，高免疫球蛋白治疗对确诊为原发性感染的孕妇具有良好的疗效，包括继发性感染后，这种效果会逐渐消失。这种有效性仅限于预防，而不是治疗 CCMV。需要更多的随机对照试验来提供具体的证据。