Assessing patient perceptions of cytomegalovirus infection in pregnancy

Abstract

Pregnant women impacted by cytomegalovirus (CMV) make clinical decisions despite uncertain outcomes. Intolerance of uncertainty score (IUS) is a validated measure of tendency for individuals to find unacceptable that a negative event might occur. We investigated patient perceptions of CMV infection during pregnancy and correlated IUS and knowledge with decision‐making. Electronic questionnaire was sent to women from July to August 2017. The questionnaire evaluated knowledge of CMV, IUS, and responses regarding management to three clinical scenarios with escalating risk of CMV including choices for no further testing, ultrasound, amniocentesis, or abortion. For each scenario, logistic regression was used to model IUS on responses. A total of 815 women were included. The majority of participants was white (63.1%) and 42% had a postgraduate degree. Over 70% reported that they had not previously heard of CMV. In the scenario with only CMV exposure, participants with increasing IUS were more likely to choose abortion (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.01, 1.06) and no further testing (OR = 0.97; 95% CI: 0.95, 0.99). In the scenario with mild ultrasound findings in setting of CMV exposure, increasing IUS was associated with higher odds of choosing no further testing (OR = 0.97; 95% CI, 0.94, 0.99). No significant association was observed between IUS and responses in the scenario with severe ultrasound abnormalities in setting of CMV exposure. The majority of patients had no knowledge of CMV. Higher IUS was associated more intervention in low severity scenarios, but in severe scenarios, IUS was not associated with participants' choices.

Seroprevalence of CMV IgG and IgM in Korean women of childbearing age

“…12 A previous study performed in the United States described that the majority of pregnant women in their study did not have knowledge of CMV. 3 Meanwhile, studies regarding the seropositivity of CMV and the risk of having a child with congenital CMV infection or patient perception of CMV infection among women of childbearing age or pregnant in Korea are limited. In South Korea, routine CMV screening using CMV IgG or IgM in women of childbearing age and/or pregnant is not recommended by national public health bodies.…”

“…2 The range of disease severity of congenital CMV infection is very wide, from normal development to sensorineural hearing loss, chorioretinitis, and cognitive or neurologic deficits that may be mild or severe. 2,3 For diagnosis of CMV infection, serology tests, such as CMV IgG and IgM, can be used. 2,4 Seroepidemiologic studies (seropositivity) using these tests can provide information on disease control because individuals with no history of exposure to CMV infection may be at high risk of primary infection, and seropositive individuals can experience reactivation of latent CMV.…”

“…CMV infection during pregnancy can result in congenital infection of the foetus 2 . The range of disease severity of congenital CMV infection is very wide, from normal development to sensorineural hearing loss, chorioretinitis, and cognitive or neurologic deficits that may be mild or severe 2,3 …”

“…2 Furthermore, this study may help to identify populations at higher risk of having a child with congenital CMV infection that require further education. 3 In conclusion, this study investigated seroprevalence of CMV IgG and IgM in Korean women of childbearing age. Considering the rate of seronegative CMV IgG in women younger than 20 years, education and prevention for young mothers may be needed.…”

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

“…Maternal perception of CMV infection during pregnancy indicates that the majority of patients had no knowledge of CMV risks. Maternal choice, with CMV exposure only or mild US findings, led to abortion or no further testing [84].…”