RESUMO
OBJECTIVE: To investigate prospectively the prevalence of congenital cytomegalovirus (CMV) infection and the pathologic features of the placenta in cases of fetal growth restriction (FGR). STUDY DESIGN: Forty-eight pregnant women who were diagnosed with FGR during pregnancy were enrolled for 15 months. Maternal CMV serologic tests, pathologic examinations of the placenta, and newborn urinary CMV-DNA polymerase chain reaction tests were performed in all the cases. The clinical characteristics and laboratory findings of the pregnant women and their newborns were collected. Biomarkers for inflammation, angiogenesis, and placental hormones were measured in the maternal serum at FGR diagnosis or in the neonatal urine at birth. RESULTS: One of the 48 cases with FGR was a congenital CMV infection. CMV antigen was detected in the placenta of 7 cases with FGR. The change rate of the estimated fetal body weight was significantly lower in FGR cases with placental CMV detection. Placental villitis was observed more frequently in FGR cases with placental CMV detection. Human placental lactogen was significantly decreased in FGR cases with placental CMV detection. Increased C-reactive protein and serum amyloid A levels in the maternal serum were observed more frequently in FGR cases with placental CMV detection. Newborn urine ß-2 microglobulin levels were significantly higher in FGR cases with placental CMV detection. CONCLUSIONS: Serologic tests for maternal CMV, the change rate of the estimated fetal body weight, analysis of several biomarkers, and placental pathologic examinations might be helpful in comprehensively predicting the possibility of congenital CMV infection.
Assuntos
Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/congênito , Retardo do Crescimento Fetal/diagnóstico , Adulto , Biomarcadores/sangue , Biomarcadores/urina , Peso Corporal , Proteína C-Reativa/análise , Infecções por Citomegalovirus/urina , DNA Viral/análise , Feminino , Retardo do Crescimento Fetal/virologia , Humanos , Imunoglobulina G/sangue , Recém-Nascido , Inflamação , Japão , Placenta/patologia , Lactogênio Placentário/metabolismo , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Estudos Prospectivos , Testes Sorológicos , Proteína Amiloide A Sérica/análise , Microglobulina beta-2/urinaRESUMO
Herein, we aimed to evaluate the occurrence of impaired renal function after cancer treatment with potentially nephrotoxic chemotherapy in children. A cross-sectional study was performed in 41 cancer survivors after chemotherapy with potentially nephrotoxic drugs. 26 (63.4%) children were detected with glomerular hyperfiltration, and urinary levels of ß-2 microglobulin (B2MG) were higher than reference range in all patients. Levels of B2MG were positively correlated with plasma creatinine and negatively correlated with glomerular filtration rate. Plasma creatinine, systolic blood pressure and cholesterol were independently associated with B2MG values. The final multivariate model for glomerular hyperfiltration risk included plasma levels of urea and of magnesium. Urinary levels of B2MG and glomerular hyperfiltration may emerge as potential biomarkers of early renal dysfunction in childhood cancer survivors.