A 2‐year study on cytomegalovirus infection during pregnancy in a French hospital

Abstract

Objectives To evaluate the proportion of pregnant women agreeing to cytomegalovirus (CMV) serologic screening. To collect data on CMV infection during pregnancy.Design Prospective study.Setting During two years, all pregnant women were informed on CMV infection. If the patient agreed, serological testing was performed around 12 weeks of gestation (WG) and, if negative, redone around 36 WG.Population Four thousand two hundred and eighty-seven pregnant women followed from 12 weeks to delivery.Methods If the first CMV serologic test was negative, detailed hygiene information was given to the parents. Diagnosis of primary infection was based on the detection of CMV-G, CMV-M and low CMV-G avidity index. When maternal infection was confirmed, diagnosis of CMV congenital infection was done in the newborns by urine culture within the three days following birth. Crude infection-rate data consisted of the number of CMV infection cases and person-time units for both exposed to hygiene CMV information (12 to 36 WG) and unexposed pregnant women (first 12 WG).Main outcome measures Rate of CMV seropositive and seronegative women. Rate of women agreeing for screening. Rate of primary infection. Rate of seroconversion. Number of CMV-infected newborns.Results Among the 4287 women followed, 3792 were either seronegative or with an unknown immune status. 96.7% out of them agreed for screening. 53.2% were initially CMV-specific IgG negative. Primary infection was detected in nine women between 0 and 12 WG (0.46%) and seroconversion was diagnosed in five women between 12 and 36 WG (0.26%) (mid P = 0.02, 95% CI [1.07-13.6]).Conclusions If clear information on CMV infection during pregnancy is given, patients frequently agree to screening. The rate of seroconversion after information, observed in this study, is low after counselling.

Awareness of and behaviors related to child-to-mother transmission of cytomegalovirus

“…In our survey we chose to ask questions about some of the behaviors that frequently have been included in experts' suggested guidelines or in prevention trials (Adler et al, 1996;Cannon and Davis, 2005;Demmler-Harrison, 2009;Picone et al, 2009). In future studies it may be useful to assess the frequency of additional behaviors.…”

“…There is evidence that maternal CMV infection may be prevented during pregnancy through education and behavioral change (Adler et al, 1996;Harvey and Dennis, 2008;Picone et al, 2009). However, prevention opportunities are missed because most women have not heard of CMV or how to prevent it (Bate and Cannon, 2011;Cannon and Davis, 2005;Jeon et al, 2006;Ross et al, 2008) and most obstetricians do not discuss CMV prevention with their patients (CDC, 2008) or are unaware of its precise transmission routes (Korver et al, 2009).…”

A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome

“…More than 50% of pregnant women in Paris area are screened for CMV and 95% in Beclere Hospital. 10 Among these 238 women, three had twin pregnancies (241 fetuses included in the study group). Mean maternal age was 31.8 years , gravidity 2 (1-8) and parity 2 (0-8).…”

Case Series of Congenital Cytomegalovirus Infection in Neonatal Period

“…The high rates for CMV serology are closely related to the level of community and poor hygienic conditions. Therefore, positive CMV serology has a confident impact and could significantly reduce the incidence of maternal CMV infection and its unfavorable effects during pregnancy (16). The effective strategy for prevention of congenital CMV infection is behavioral and educational interventions in CMV seronegative women.…”