Congenital cytomegalovirus infection and small for gestational age infants

Simonazzi, Giuliana; Curti, Alessandra; Murano, Paola; Cervi, Francesca; Contoli, M.; Lazzarotto, Tiziana; Capretti, Maria Grazia; Rizzo, Nicola; Guerra, Brunella

doi:10.1002/pd.4362

Cited by 7 publications

(2 citation statements)

References 32 publications

(29 reference statements)

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“…In addition, a negative IgM result does not necessarily rule out a primary infection with CMV as samples collected too early in the course of a primary infection may not have detectable levels of IgM and it may reappear during reactivation of CMV [27]. On the other hand, the low prevalence of CMV specific IgM is possibly due to the fact that the majority of the women would have recovered from the primary in¬fection, with the loss of IgM, by the time they reach child bearing age 30 Primary CMV infection was identified as sero-conversion in previously CMV seronegative women or by detection of CMVspecific IgM combined with low avidity anti-CMV IgG [31]. Moreover, the pre conception immunity against CMV provides only partial protection from intrauterine transmission of the virus [18].…”

Section: Discussionmentioning

confidence: 99%

The Sero-Prevalence of Cytomegalovirus Infection among Women with Abortion and Intrauterine Death in Erbil City Kurdistan Region , Iraq

Ali¹

2020

DJM

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Background: Cytomegalovirus (CMV) is a major causative agent of prenatal and perinatal infections and may lead to important complications on pregnancy. Objective: To find out the sero-prevalence of CMV IgM and IgG and its association with the history of abortion and / or intra-uterine death, as well as, to study the association between the mentioned prevalence with some socio-demographic variables. Patients and Methods: A case-control study was performed during the period between October 2018 to April 2019 in Erbil city (Kurdistan region, Iraq) on 75 pregnant women with history of abortion and / or intra-uterine death; and 75 healthy women with normal pregnancy who served as a control group. The women had been referred to the central laboratory department of the Maternity Teaching Hospital for the detection and evaluation of sero-prevalence of CMV specific IgM and IgG markers. The study was approved by the Ethics Committee of Health Sciences College, Hawler Medical University and informed consent was obtained from the patients and controls. Results: The sero-prevalence of CMV-specific IgG was 100% in each of the study groups. The sero-prevalence of CMV-specific IgM was 8% among women with abnormal pregnancy, while, none of the women of the control group had a positive IgM. No significant association was detected between CMV-specific IgM sero-prevalence and any of the studied sociodemographic factors as well as risk factors including abortion, intrauterine death and hypertension (p>0.05). Conclusion:The association was detected between the CMV-specific IgM sero-prevalence and history of abortion and / or intra-uterine death but no significant may be due to small sample size in the present study.

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Section: Discussionmentioning

confidence: 99%

The Sero-Prevalence of Cytomegalovirus Infection among Women with Abortion and Intrauterine Death in Erbil City Kurdistan Region , Iraq

Ali¹

2020

DJM

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“…No other studies of ZIKV-exposed infants have focused on SGA as a risk factor for adverse infant outcomes. In other congenital infections, little has been published about SGA as a risk factor for adverse outcomes [27][28][29]. Approximately 43% of SGA infants were found to have a neurologic, ophthalmologic, or hearing abnormality in comparison to only 18% of NSNM infants (OR, 3.4; 95% CI, 1.1-10.7); 21% had seizures and 43% had abnormal neuroimaging compared to only 16% of NSNM infants (OR, 3.9; 95% CI, 1.2-12.8).…”

Section: Discussionmentioning

confidence: 99%

Early Clinical Infancy Outcomes for Microcephaly and/or Small for Gestational Age Zika-Exposed Infants

Adachi

Romero

Nielsen‐Saines

et al. 2019

Clinical Infectious Diseases

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Background Zika-exposed infants with microcephaly (proportional or disproportional) and those who are small for gestational age without microcephaly should be closely followed, particularly their growth trajectories. They are at high risk of adverse outcomes in the first year of life. Antenatal Zika virus (ZIKV) exposure may lead to adverse infant outcomes including microcephaly and being small for gestational age (SGA). ZIKV-exposed infants with a diagnosis of microcephaly (proportional [PM] or disproportional [DM]) or SGA at birth were evaluated with anthropometric measurements and health outcomes. Methods Infants had laboratory-confirmed ZIKV exposure in Brazil. PM, DM, or SGA classification was based on head circumference and weight. First-year growth parameters and clinical outcomes were recorded with analyses performed. Results Among the 156 ZIKV-exposed infants, 14 (9.0%) were SGA, 13 (8.3%) PM, 13 (8.3%) DM, and 116 (74.4%) were neither SGA nor had microcephaly (NSNM). High rates of any neurologic, ophthalmologic, and hearing abnormalities were observed for PM (100%), DM (100%), and SGA (42.9%) vs NSNM infants (18.3%; P <.001); odds ratio [OR], 3.4 (95% confidence interval [CI], 1.1–10.7) for SGA vs NSNM. Neuroimaging abnormalities were seen in 100% of PM and DM and in 42.9% of SGA vs NSNM infants 16%; (P <.001); OR 3.9 (95% CI, 1.2–12.8) for SGA vs NSNM. Growth rates by z score, particularly for microcephaly infants, were poor after birth but showed improvement beyond 4 months of life. Conclusions ZIKV-exposed infants with microcephaly (PM and DM) had similarly high rates of adverse outcomes but showed improvement in growth measurements beyond 4 months of life. While SGA infants had fewer adverse outcomes compared with microcephaly infants, notable adverse outcomes were observed in some; their odds of having adverse outcomes were 3 to 4 times greater compared to NSNM infants. Zika-exposed infants with microcephaly, irrespective of being proportional or disproportional, and those who are small for gestational age without microcephaly should be closely followed, particularly their growth trajectories. They are at high risk of adverse outcomes in the first year of life.

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Intrauterine therapy of cytomegalovirus infection with valganciclovir: review of the literature

Seidel

Feiterna‐Sperling

Siedentopf

et al. 2017

Med Microbiol Immunol

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Congenital cytomegalovirus (CMV) infection is the leading cause for sensorineural hearing loss and mental retardation in children without genetic diseases worldwide. There is little evidence guiding therapeutic strategies during pregnancy when intrauterine fetal CMV infection is confirmed. We provide a systematic review of the use of ganciclovir (GCV) or VGCV during pregnancy discussing safety of its use for mother and fetus and describe two cases of intrauterine therapy of fetal CMV infection with valganciclovir (VGCV). A PubMed database search was done up to November 16, 2016 without any restrictions of publication date or journal, using the following keywords: "valganciclovir" or "ganciclovir" and "pregnan*". Furthermore, citations were searched and expert references were obtained. Reported cases were considered if therapy was in humans and initiation of treatment of the CMV infection was during pregnancy. In total, seven case reports were retrieved which described GCV or VGCV use during pregnancy for fetal or maternal CMV infection. In the four cases of treatment for maternal CMV infection, no negative effects on the fetus were reported. Three cases of GCV administration to pregnant woman with the intention of fetal treatment after proven fetal infection were found. We additionally present two cases of VGCV treatment in pregnancy from our center of tertiary care. VGCV seems to be a safe treatment for congenital CMV infection for the mother and the fetus. Therapeutic concentrations can be achieved in the fetus by oral intake of the mother and CMV replication can be suppressed. Larger studies are needed to evaluate this therapeutic intervention and the long-term effects.

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Congenital cytomegalovirus infection and small for gestational age infants

Abstract: Congenital CMV infection does not seem to be associated with a higher incidence of SGA, and long-term outcomes do not seem to be affected by isolated impaired fetal growth.

Cited by 7 publications

References 32 publications

The Sero-Prevalence of Cytomegalovirus Infection among Women with Abortion and Intrauterine Death in Erbil City Kurdistan Region , Iraq

The Sero-Prevalence of Cytomegalovirus Infection among Women with Abortion and Intrauterine Death in Erbil City Kurdistan Region , Iraq

Early Clinical Infancy Outcomes for Microcephaly and/or Small for Gestational Age Zika-Exposed Infants

Intrauterine therapy of cytomegalovirus infection with valganciclovir: review of the literature

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