| Pregnancy is a process ,in which the embryon and fetus growth and develop in the mother's body. Both the mother and fetus are subject to many internal and external factors, In this complex and lengthy process.Many adverse factors may lead to pathological pregnancy.In early pregnancy,this factors may lead to abortion, ectopic pregnancy and hyperemesis gravidarum. In advanced pregnancy, they may lead to gestational hypertension, placenta previa, placental abruption, fetal distress, polyhydramnios or oligohydramnios, preterm labor, premature rupture of memberane, multiple pregnancy ,postterm pregnancy etc. In addition, stillbirths and fetal developmental abnormalities, such as fetal growth restriction and fetal malformations,could also be caused by this factors.Rubella is a acute respiratory infectious disease caused by the rubella virus,that commonly happened in children, adults can also be infected. Most infected people are with mild symptoms and fewer complications. But if women are infected with rubella during pregnancy,it can cause not only their illness,but also lead to intrauterine fetal infection.It can even caused newborn birth defects or abnormal development. Infection is characterized by infected pregnant women's usually minor symptoms, or even no obvious clinical symptoms.But the rubella virus can infect the fetus through the placenta or obstetric canal.And it can cause miscarriages, stillbirths or congenital rubella syndrome(CRS),with which infants could suffer serious damage of organs with different clinical manifestations. CRS is the worst thing caused by rubella. CRS dosen't happen only in infants. Some people is in the absence of any abnormal syndrome after birth. But lesions can be worse and worse,which eventually developed into permanent damage and tardus damage with age increased.Rubella is epidemic in Australia 1940. A young ophthalmologist named Gregg found that the incidence of cataract increased significantly,and the majority of mothers infected by rubella virus in the early stages of pregnancy in 1941. That led to people's attention[9].Between 1962 and 1965, rubella epidemic in Europe and the United States,which caused abortion of 10000 pregnant women and 20000 birth defects in infants.It proved that rubella is the main reason for birth defects[10]. China has very little information about patients with the CRS,which was first reported in 1984[33]. One case was reported of newborns with congenital heart disease in 1986.The mother was infected by rubella in the third month of pregnancy which was confirmed by in the serum[34]. According to domestic scholars Dai Bin[35]research report of 1990: In the six provinces (municipalities)of Beijing, Liaoning, Shaanxi, Henan, Jiangsu and Inner Mongolia, there were 48 women with their rubella RV-IgM positive from 10412 women in early pregnancy detection of serum .The positive rate is 0.461%. Of which 29 in the 9126 outpatient pregnant women are positive. The positive rate was 0.318%. In the 1990s, China's annual number of newborns born are around 25 million. According to the rubella infection rate of 0.318 percent early stages of pregnancy,80000 pregnant women were in the primary infection.Only after 50% of the originalinfection of the fetus will turn into malformations, each year more than 20000 babies born are caused congenital malformations due to rubella virus intrauterine infection. It showed that rubella virus infection has caused to a enormous social and family burden.In recent years the investigation of domestic rubella antibody levels for women of childbearing age and rubella infection in the first trimester have done a lot.The survey results showed that rubella virus infections in China were different due to endemic areas and socio-economic status, but were higher than Southeast Asia and the Western Pacific Region calculated rubella infection rates in women of childbearing age.It proved the existence of rubella outbreak in China, and the threat of early pregnancy women was widespread.And it also affected the CRS morbidity[36]. Currently, WHO and the United States have developed a reliable definition of CRS monitoring,and some developing countries have been carrying out monitoring and investigation of the CRS.But the incidence of the CRS and epidemiological research is still blank in China.There is no relevant data,and there is an urgent need to collect relevant information to analysis. This study aimed at assessing the maternal rubella susceptibility and providing scientific basis for the prevention and control of congenital rubella syndrome by summing up the whole nation's rubella epidemic and detecting the rubella antibody of maternal neonatal cord blood sample of Changchun City.The experimental applicated of enzyme-linked immunosorbent assay to detect of the rubella virus-specific IgG antibody (RV-IgG) from 21-41-year-old maternal neonatal cord blood, as well as analyzing the factors which may affect the level of maternal rubella antibody through Concise statistical software10.32. X2 statistical test was used. It's considered statistically significant ,when p <0.05.The results show that:â‘ . The Chinese incidences of rubella are 1.9576/100 thousands ,2.8312/100 thousands and 5.6864/100 thousands in 2005, 2006 and 2007 respectively.The incidence of rubella was seasonal,and the peak of the incidence was between April and June.The victim are mainly under the age of 20 ,which mainly including students, scattered children, preschool children;â‘¡. 2005, 2006, 2007the rubella incidence of 20 to 39-year-old women, that were also in the childbearing age, were respectively 10.23%, 10.52% and 18.53% of the total incidence.â‘¢.The total rubella antibody positive rate was 82.78 percent of the 180 Changchun women's neonatal cord blood.â‘£. The rubella antibody positive rate decline with the growth of the age of 21 to 41-year-old pregnant women in Changchun City. Various age groups'antibody positive rates showed a statistically significant. While in the region, gestational age and factors such as the history of spontaneous abortion groups, the difference was not statistically significant. Changchun and other domestic provinces and cities'maternal rubella antibody positive rate marked regional differences.So the conclusions are as follows:â‘ rubella epidemic situation is grim in China: China's total number of rubella incidence showed a rising trend in the recent years ;Although there are incidence of rubella in all ages, but it's mainly in the under 20 years of age. The incidence of rubella can be found all over the whole country,and it's mainly in the students scattered children, preschools etc. But the rubella incidence of 20 to 39-year-old women have a trend of growth in the total number of women of the incidence in recent years.â‘¡21 to 41-year-old maternal rubella antibody distribution and influencing factors in Changchun City: 21 to 41-year-old maternal rubella antibody positive rate is 82.78percent, and it's age-related. Along with the increasing of age, there is a downward trend of the positive rate. The positive rate are differences, but that not because of and the gap between urban and suburb,gestational age,or whether with an abnormal pregnancy-birth history.â‘¢The risk of rubella-infected among 21 ~ 41-year-old pregnant women in Changchun City: The total maternal rubella antibody-negative rate of 21 to 41-year-old pregnant women is 17.22%.So the risk of suffering from rubella is nearly 17.22 percent among 21 to 41-year-old pregnant women in Changchun City.Recommendations:â‘ Strengthen the monitoring of rubella and CRS ,and strengthen the construction of diagnosis of rubella laboratory network.At the same time strengthen the immune awareness of the entire population and improve their medical knowledge.Take rubella vaccination into the children's immunization as soon as possible, in order to avoid rubella infection of children,which is the rubella infection source of pregnant women and women of childbearing age;â‘¡Screen premarital childbearing age women rubella virus lgG antibody,antibody-negative women are susceptible.They should be given live attenuated rubella vaccine.They could be pregnant after the antibody turning positive three months or six months later;â‘¢Detect the serum rubella virus lgM antibody of early pregnancy (1-3month)women.The first confirmed rubella infection pregnant women should be persuaded to terminate the pregnancy;â‘£In the rubella epidemic season, pregnant women should avoid contact with patients of rubella,and should go to public places as less as possible to reduce the risk of rubella infection. |
