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. STUDY DESIGN 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; p:0.03) and high levels of gamma-glutamyl transpeptidase (GGT) (≥151 IU/L; p:0.02) 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), β2 microglobulin >10.4 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.

中文翻译：

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根据脑损伤的严重程度和脐带穿刺妊娠的妊娠中期，感染巨细胞病毒的胎儿的血液参数。

背景和目的巨细胞病毒（CMV）仍然是先天性感染和疾病的主要原因。在怀孕期间，可以通过超声（US）特征检测出有症状的病例，但是，很难进行预后评估。这项研究的目的是评估在CMV感染的胎儿中特定血液参数的预测价值。研究设计包括28例经脐静脉穿刺术感染CMV的胎儿。根据产前US / MRI脑损伤，胎儿被认为受到了严重或轻度的影响。评估胎儿血液参数以预测严重的脑部异常，并根据妊娠中期进行比较。进行逻辑回归和接收器工作曲线分析。结果血小板减少症（≤100,000/ mm3; p：0。03）和高水平的γ-谷氨酰转肽酶（GGT）（≥151IU / L; p：0.02）表示严重程度。为了预测脑损伤，GGT≥183 UI / l达到71％的敏感性，83％的特异性（AUC：0.78）和OR为2.05（95％CI：1.22-3.43）每增加100 IU / l，调整为胎龄。然而，血小板减少症（91％vs 50％; p：0.04），β2微球蛋白> 10.4 mg / l（60％vs 0％p：0.03），CMV-DNA> 50,000拷贝/ ml（80％vs 25％; p：在≤28周采样的严重受损胎儿中，其IgM阳性（70％比17％； p：0.04）的发生率要明显高于此后。结论在感染了CMV的胎儿中，血小板减少症和高水平的GGT与严重的US / MRI脑异常有关。但是，在受严重影响的胎儿中，除GGT外，血液参数会根据胎龄而变化。