A cross-sectional study on maternal anxiety levels after cytomegalovirus screening

Uehara, Kanako; Kaneko, Masatoki; Matsuoka, Ayako; Kuroki, Mana; Minematsu, Toshio

doi:10.1080/0167482x.2019.1658734

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…A key principle that must be fulfiled to offer universal screening is the assessment of the range and extent of benefits and harms. A positive screening result has been shown to increase the anxiety levels of pregnant women 31 . The negative impact of this anxiety is evident in the observed choices of women in a retrospective cohort study of serological screening in pregnancy from Israel.…”

Section: Discussionmentioning

confidence: 99%

“…A positive screening result has been shown to increase the anxiety levels of pregnant women. 31 The negative impact of this anxiety is evident in the observed choices of women in a retrospective cohort study of serological screening in pregnancy from Israel. This study found that the rate of termination of pregnancies doubled in women with positive CMV IgM, with many women electing to terminate prior to further investigation with amniocentesis.…”

Section: Main Findingsmentioning

confidence: 99%

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Serological screening for cytomegalovirus during pregnancy: A systematic review of clinical practice guidelines and consensus statements

et al. 2023

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Background Congenital cytomegalovirus (cCMV) is the most common congenital infection worldwide. cCMV can lead to severe long‐term sequelae, including neurological impairment and developmental delay. We performed a systematic review of clinical practice guidelines containing recommendations concerning serological screening for CMV during pregnancy. Method We performed a search of MEDLINE, Turning Research into Practice (TRIP) database and the grey literature for clinical practice guidelines or consensus statements published in the English language from Jan 2010 to June 2022. The quality of the included guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Textual synthesis was used to summarise and compare the recommendations on CMV serological screening in pregnancy. Results Eleven guidelines and two consensus statements were included. None recommended universal serological screening for CMV in pregnant women; five recommended screening for high‐risk women (those with frequent contact with young children). The overall quality of the guidelines varied; most were medium or low. Conclusions Although clinical practice guidelines do not actively recommend routine serological screening in pregnancy, most did not meet standard processes for development and predated the emerging data on valaciclovir as a potential intervention. Existing recommendations are underpinned by limited, low‐level evidence, exposing the lack of robust data in this area of practice. Further high‐level evidence and methodologically robust guidelines are needed to guide clinical practice in this rapidly changing field.

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Section: Discussionmentioning

confidence: 99%

Section: Main Findingsmentioning

confidence: 99%

Serological screening for cytomegalovirus during pregnancy: A systematic review of clinical practice guidelines and consensus statements

et al. 2023

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“…Studies from Italy and Israel show that up to 36% of pregnant women with serological evidence of recent CMV infection terminate without diagnostic confirmation of fetal infection with amniocentesis 11,12 . Although the reasons for the terminations were not reported in these studies, prenatal CMV screening has been reported to increase anxiety levels, which may contribute to a decision to not wait for fetal diagnostic testing 13 …”

Section: Introductionmentioning

confidence: 91%

“The anxiety coming up to every scan—It destroyed me”: A qualitative study of the lived experience of cytomegalovirus infection during pregnancy

Tripathi,

Watson,

Skrzypek

et al. 2024

Prenatal Diagnosis

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BackgroundEmerging evidence supporting the use of valaciclovir to reduce fetal infection after maternal primary cytomegalovirus (CMV) infection has stimulated interest in routine CMV serological screening in pregnancy. It is important to understand the healthcare consumer perspective of a CMV infection during pregnancy to minimize unintended harms of screening.MethodsWe conducted a qualitative study using semi‐structured interviews with Australian women who had a lived experience of CMV infection following serological testing during pregnancy. Participants were recruited via social media and healthcare consumer networks, and purposively selected to capture a range of perinatal outcomes. Interview transcripts were analyzed using inductive content analysis.ResultsTwelve participants were interviewed: 6 had a live birth, 4 had terminations of pregnancy, 1 had a neonatal death and 1 was pregnant at the time of interview. Four major categories emerged from the analysis. Women reported a lack of CMV awareness among themselves, their social networks, and among their health care providers. The participants described their experience as “hard” and “stressful”. Uncertainty and variability characterized their clinical decision‐making process. The pregnancy and postpartum periods were marked by ongoing anxiety about the long‐term impacts of CMV. Women supported screening for CMV, decision making and reproductive choice, but acknowledged that routine testing may not be desired by everyone and may increase stress and terminations of pregnancy. Important coping strategies included obtaining support from partners, family, and other families with lived experience of CMV, as well as having access to knowledgeable and sensitive healthcare professionals.ConclusionSerological diagnosis of maternal CMV infection during pregnancy can have severe and prolonged psychological impacts on parents, regardless of the pregnancy outcome. Improving healthcare professionals' knowledge and public awareness are essential before widespread serological screening can be responsibly introduced. Healthcare administrators that are considering implementing a prenatal screening program for secondary prevention of fetal CMV infection should pay attention to consumer perspectives to minimize unintended harms to women and their families.

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“…This includes inappropriate termination of pregnancy because of positive CMV IgM or too long a delay in providing with a diagnostic test or in cases based solely on positive CMV PCR in the amniotic fluid. 39 This illustrates 3 theoretical situations, which should be considered separately. The first one solely reflects medical ignorance; it is not unique to congenital CMV and should not happen because due diligence in a rapidly evolving field such as congenital CMV is both a medical and an ethical duty.…”

Section: Clinical Perspectivementioning

confidence: 98%

Advocating for cytomegalovirus maternal serologic screening in the first trimester of pregnancy: if you do not know where you are going, you will wind up somewhere else

Ville

2021

American Journal of Obstetrics & Gynecology MFM

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A cross-sectional study on maternal anxiety levels after cytomegalovirus screening

Cited by 4 publications

References 26 publications

Serological screening for cytomegalovirus during pregnancy: A systematic review of clinical practice guidelines and consensus statements

Serological screening for cytomegalovirus during pregnancy: A systematic review of clinical practice guidelines and consensus statements

“The anxiety coming up to every scan—It destroyed me”: A qualitative study of the lived experience of cytomegalovirus infection during pregnancy

Advocating for cytomegalovirus maternal serologic screening in the first trimester of pregnancy: if you do not know where you are going, you will wind up somewhere else

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