目的调查江苏省中孕期妇女的巨细胞病毒(cytomegalovirus,CMV)血清流行率,探讨母孕期感染状态与不良妊娠结局的相关性。方法根据2002-2004年江苏省12个市县17 661例孕妇的新生儿结局,527例有不良妊娠结局的孕妇纳入病例组,同时随机选取496例正常妊娠结局的孕妇为正常对照。检测孕妇妊娠15~20周外周血CMV IgG、IgM和IgG亲合力指数(avidity index,AI)。结果 1023例孕妇的CMV IgG阳性率为98.7%,其中病例组和对照组孕妇阳性率分别为99.4%和98.0%(P=0.039)。病例组孕妇活动感染率,即CMV IgG+/IgM+,明显高于正常对照组(3.8%vs.1.6%,P=0.033)。CMV IgG AI检测结果显示,对照组孕妇AI均大于30%,说明无原发感染,而病例组孕妇5例(0.9%)AI<30%,提示原发感染(P=0.084),这5例母亲的新生儿均出现不良妊娠结局,包括新生儿死亡、头颅畸形和化脓性脑膜炎各1例,生长发育迟缓2例。多因素回归分析表明,母孕期CMV活动性感染是不良妊娠结局的独立危险因素(aOR 8.65,95%CI1.85-40.41,P=0.006)。此外,母亲低学历和有既往不良妊娠史亦增加妊娠不良结局的发生风险。结论 CMV感染在江苏地区孕妇人群中普遍存在。尽管仅少部分孕妇在孕期发生活动性感染,但仍是造成妊娠不良结局的独立危险因素。因此,应监测孕妇CMV感染状态并正确进行胎儿或新生儿感染风险的评估。 Objective To investigate the seroprevalence of cytomegalovirus (CMV) among women during pregnancy in Jiangsu Province and to explore the correlation between the infection status during pregnancy and adverse pregnancy outcome. Methods According to the neonatal outcomes of 17 661 pregnant women in 12 cities and counties of Jiangsu Province from 2002 to 2004, 527 pregnant women with adverse pregnancy outcomes were included in the case group. Meanwhile, 496 pregnant women with normal pregnancy outcomes were randomly selected as normal controls. Peripheral blood CMV IgG, IgM and IgG avidity index (AI) were detected in 15-20 weeks pregnant women. Results The positive rate of CMV IgG in 1023 pregnant women was 98.7%. The positive rates of CMV in cases and controls were 99.4% and 98.0% respectively (P = 0.039). The infection rate of pregnant women in the case group, namely CMV IgG + / IgM +, was significantly higher than that of the normal control group (3.8% vs 1.6%, P = 0.033). CMV IgG AI test results showed that AI in pregnant women in the control group was more than 30%, indicating that no primary infection was found in 5 pregnant women (0.9%) AI <30%, indicating primary infection (P = 0.084) Neonatal mothers have adverse pregnancy outcomes, including neonatal death, head deformities and purulent meningitis in 1 case, growth retardation in 2 cases. Multivariate regression analysis showed that active CMV infection during pregnancy was an independent risk factor for adverse pregnancy outcomes (aOR 8.65, 95% CI 1.85-40.41, P = 0.006). In addition, low maternal mothers with previous history of adverse pregnancy also increased the risk of adverse pregnancy outcome. Conclusion CMV infection is common in pregnant women in Jiangsu Province. Although only a minority of pregnant women have an active infection during pregnancy, they are still independent risk factors for poor outcome in pregnancy. Therefore, pregnant women should be monitored for CMV status and correctly assessed for the risk of fetal or neonatal infection.