妊婦における抗パルボウイルス抗体保有状況

ヒト・パルボウイルス(B19)は伝染性紅斑の原因ウイルスとして知られているが, 近年胎内感染により胎児水腫を惹き起こすことが報告され注目されている. しかし本邦では妊婦のB19抗体保有率などに関しては報告がない. われわれはすでに報告した間接螢光抗体法を用いて本邦における一般人の抗体保有状況, 正常妊婦の抗体保有率, 初期流産した妊婦や非免疫性胎児水腫(NIHF)例の抗体陽性率について検討した. 16〜64歳までの一般人(献血者)の抗B19・IgG抗体陽性率は47%であったが, 21〜30歳で22%, 31〜40歳で44%, 41〜50歳で65%, 51〜60歳で76%と年齢と共に上昇した. 正常妊婦329名では抗B19・IgG抗体陽性率が33%であったが, 一般人と同様に21〜30歳で26%, 31〜40歳で44%と年代で有意差が認められた. すなわち20代の妊婦で約3/4, 30代の妊婦で約1/2が抗B19抗体陰性で妊娠中にB19感染の危険があるといえる. 初期流産23例中IgG抗体陽性は9例(39.1%)であった. 妊婦で6例のIgM陽性例が見つかったが, 1例が人工妊娠中絶, 1例が自然流産, 4例が自然分娩で胎児水腫となった症例はなかった. またNIHF24例でIgG抗体陽性が4例あったがIgM陽性例やIgG抗体価が上昇したり陽転した症例はなかった. 今回の調査ではB19感染とNIHFの因果関係を証明できた症例はなかったが今後さらに症例を集め検討する必要がある.
Human parvovirus B19 (B19) has been shown to be associated with erythema infectiosum. Recently, it was reported that when a pregnant woman is infected with B19, the fetus in her uterus sometimes becomes hydropic and results in a stillbirth. But no epidemiologic study of pregnant women in Japan has been performed yet. We have established an in vitro propagation system of B19 virions and an assay system for detecting anti-B19 antibody by indirect immunofluorescence (IF) staining. We examined the positive rate of anti-B19 antibody among 337 normal blood donors, 329 normal pregnant women, 23 early aborted women and 24 non-immune hydrops fetalis cases by IF staining. The positive rate for anti-B19 IgG among normal blood donors increased with age. It was 22% aged 21 to 30, 44% aged 31 to 40, 65% aged 41 to 50, and 76% aged 51 to 60, respectively. Anti-B19 IgG was detected in 33% of 329 of normal pregnant women. The anti-B19 IgG positive rate was 26% in pregnant women in their twenties and 44% in those in their thirties. There was a significant difference between the two generations. The results show that more than half the women in their twenties and thirties risk B19-infection during pregnancy. Nine of twenty-three early aborted women were positive for anti-B19 antibody. Among six pregnant women who were positive for anti-B19 IgM, four delivered normal babies and the others aborted artificially or spontaneously. Anti-B19 IgG and IgM of twenty four non-immune hydrops fetalis (NIHF) were examined and four cases were found to be anti-B19 IgG positive. However, we did not obtain evidence that B19 was responsible for these NIHF cases. We need to further study the relation between B19 infection and NIHF.

収集根拠 : NII-ELS
資料形態 : テキストデータ
コレクション : 国立国会図書館デジタルコレクション > 電子書籍・電子雑誌 > 学術機関 > 学協会
著者所属: 東北大学医学部産科婦人科学教室
著者所属: 宮城県保険環境センター
著者所属: 東北大学医学部細菌学教室
Affiliation: Department of Obstetrics and Gynecology Tohoku University School of Medicine
Affiliation: Miyagi Prefectural Institute of Public Health
Affiliation: Department of Microbiology, Tohoku University School of Medicine