Trial Lecture - time and place
See Trial Lecture.
Adjudication committee
- 1. opponent: Seniorprofessor Tomas Bergström, Sahlgrenska Academy, Göteborg
- 2. opponent: Professor Guttorm Nils Haugen, University of Oslo
- 3. member of the adjudication committee: Professor Anne Margarita Dyrhol-Riise, University of Oslo
Chair of the Defence
Professor Espen Bjertness, University of Oslo
Principal Supervisor
Professor Per Minor Magnus, University of Oslo
Summary
Cytomegalovirus and parvovirus B19 infections during pregnancy can result in adverse outcomes. The aims of the thesis were to estimate the susceptibility rates and the incidence of infections among pregnant women as well as the prevalence of congenital infections in Norway. We performed a case-control study nested within the Norwegian Mother and Child Cohort Study, and estimated the odds ratio for perinatal death according to presence of maternal infection with parvovirus B19. The case group consisted of 149 women with a late miscarriage or perinatal death. The control group included 1349 randomly selected women. The laboratory methods included antibody analysis, avidity testing and PCR analysis. We found that 40% of pregnant women were susceptible for cytomegalovirus and parvovirus B19, and that 2.2% and 3.7 %, respectively, had an infection during pregnancy. We found low concentrations of parvovirus B19 DNA in similar number of cases and controls. We conclude that one should be cautious in diagnosing a parvovirus B19 infection purely based on detection of parvovirus DNAemia. When investigating umbilical cord blood, we found a prevalence of congenital cytomegalovirus infection of 0.2%. We compared this result with the number of children registered with the ICD-10 diagnosis code; congenital cytomegalovirus infection in the Norwegian Patient Registry, and found that very few children are given this diagnosis at birth. Previous infection status for CMV was associated with the number of previous births and with low educational attainment. From information given in the medical records, we classified perinatal death cases using the Causes Of Death and Associated Conditions classification system. Only a few of the perinatal death cases had an optimal investigation performed regarding CMV and parvovirus B19. We found that diagnostics of these infections during pregnancy were challenging, and that consecutive samples often was necessary to confirm an infection.
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