| Yield and costs of screening growth-retarded infants for torch infections. | |
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MedLine Citation:
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PMID: 11012137 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Many infants with intrauterine growth retardation (IUGR) are screened for TORCH infections. The yield and costs of such a practice may not be justifiable. Medical charts of infants with IUGR who had a workup for toxoplasmosis, other (infections), rubella, cytomegalovirus (infection), and herpes (simplex) (titer) (TORCH) infections were reviewed for the presence of clinical findings, laboratory and head ultrasound abnormalities associated with intrauterine infections. Maternal charts and reports of placental pathology were reviewed for identifying maternal illnesses and placental causes associated with IUGR. Seventy-five out of 182 infants (41%) with IUGR had a workup for TORCH infection. Maternal conditions associated with IUGR included: pregnancy-induced hypertension (19%), tobacco use (43%), alcohol abuse (21%), illicit drug use (24%), chronic hypertension, diabetic vasculopathy or collagen vascular disease (12%), and multiple gestation (3%). Placental pathology was available in 53/75 cases. Thirty-six of fifty-three (67%) placentae had abnormalities associated with IUGR: placental infarcts (22 of 36), vasculitis/villitis (15 of 36), placenta previa (1 of 36), abruptio placenta (2 of 36), and velamentous insertion of umbilical cord (1 of 36). Clinical findings among infants included hepatosplenomegaly, cataract or rash (1 of 75), thrombocytopenia and/or neutropenia and/or direct hyperbilirubinemia (11 of 75). Seven out of 75 infants had dysmorphic features. None of the infants (0 of 75) had positive IgM titers for toxoplasma, rubella, cytomegalovirus (CMV), or herpes simplex virus (HSV). No infants (0 of 43) had elevated total IgM titers; one infant (1 of 57) had a positive urine culture for CMV. One infant had evidence of calcifications on head ultrasound and a second infant had hydrocephalus (2 of 43). The costs associated with workup for TORCH infections among 75 infants included: TORCH titers determination: $17,816, total IgM titers: $1318, urine culture for CMV: $5734, and head ultrasound: $28,165. The yield of workup for TORCH infection among infants with IUGR is poor and does not justify the incurred costs. |
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Authors:
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N A Khan; S N Kazzi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of perinatology Volume: 17 ISSN: 0735-1631 ISO Abbreviation: Am J Perinatol Publication Date: 2000 |
Date Detail:
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Created Date: 2001-01-03 Completed Date: 2001-01-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 131-5 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan 48201, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Fetal Growth Retardation / etiology* Humans Infant, Newborn Medical Records Michigan Outcome Assessment (Health Care)* Pregnancy Pregnancy Complications, Infectious / diagnosis* Pregnancy Outcome Prenatal Diagnosis / economics* Retrospective Studies |
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