Awareness and knowledge of congenital cytomegalovirus infection among pregnant women and the general public: a web-based survey in Japan

Abstract

Background The best approach to reduce congenital cytomegalovirus infection (cCMVi) is to practice behaviors that reduce cytomegalovirus (CMV) transmission during pregnancy. Expanding awareness and knowledge of CMV is expected to result in increased practice of preventative behaviors. To this end, it is necessary to understand current awareness and knowledge of CMV. Methods This web-based cross-sectional survey assessed the awareness and knowledge of cCMVi among pregnant women and the general public in Japan. Participants aged 20–45 years (pregnant and non-pregnant women, and men) were identified from a consumer panel. Study outcomes (all participants) included awareness of cCMVi and other congenital conditions. Among those aware of cCMVi, outcomes included knowledge of CMV transmission routes, long-term outcomes of cCMVi, and behaviors to prevent CMV transmission during pregnancy. Outcomes limited to pregnant women included the practice of preventative behaviors and opinion on how easy it is to implement these behaviors. The data of the pregnant group (pregnant at the time of the survey) were compared with those of the general group (non-pregnant women and men). Results There were 535 participants in the pregnant group and 571 in the general group. Awareness of cCMVi was generally low (pregnant, 16.1%; general, 10.2%). Pregnant participants were significantly more aware of most congenital conditions than those in the general group, including cCMVi (P = 0.004). Knowledge about CMV/cCMVi was limited; there were no significant differences between the two groups for 24 of the 26 knowledge questions. A small proportion (one third or less) of pregnant women practiced behaviors to prevent the transmission of CMV, though most (73.3–95.3%) pregnant women who were aware of cCMVi considered such behaviors easy to implement. Conclusions Awareness and knowledge of CMV/cCMVi is low among pregnant women in Japan; the level of knowledge is similar to that among the general public. This needs to be improved. Most pregnant women considered behaviors to prevent CMV transmission easy to perform, which indicates that effectively educating pregnant women regarding the long-term outcomes of cCMVi, CMV transmission routes, and preventative behaviors will contribute to a reduced incidence of cCMVi. Trial registration UMIN Clinical Trials Registry, UMIN000041260.

Primary, Secondary, and Tertiary Prevention of Congenital Cytomegalovirus Infection

“…A low level of CMV-related knowledge was also found among woman of childbearing age and/or pregnant woman in other studies [45,[47][48][49][50]. This rate varies greatly from one country to another, with a percentage of knowledge of less than 20% reported in some studies conducted in Ireland, the USA, Holland, Japan, Saudi Arabia, and Australia [32,[47][48][49][51][52][53]. Three studies conducted in Canada, the USA, and England between 2019 and 2021 reported a rate of CMV awareness among pregnant women of between 32.4% and 39% [44,54,55], while three other studies conducted in Switzerland, Italy, and France showed rates of awareness among pregnant women ranging from 39% to 60% [15,56,57].…”

“…Indeed, a study conducted in Japan between 2012 and 2016 showed no change in knowledge about the virus in the population of pregnant women, who maintained an extremely low knowledge rate over the study years (7% over 6 years) [46]. A low level of CMV-related knowledge was also found among woman of childbearing age and/or pregnant woman in other studies [45,[47][48][49][50]. This rate varies greatly from one country to another, with a percentage of knowledge of less than 20% reported in some studies conducted in Ireland, the USA, Holland, Japan, Saudi Arabia, and Australia [32,[47][48][49][51][52][53].…”

“…A comparison between women's knowledge of CMV and knowledge of other infections or diseases that can infect the fetus has been conducted by some authors. All results showed that women's knowledge of CMV was much lower than their knowledge of toxoplasmosis or Down syndrome, which, however, have a lower incidence than CMV infection [44,48,50,53,56,57,59,60]. In the United States, the number of children born with cCMV and its long-term sequelae is estimated at 8600 per year, which is much higher than the number of children born over the same period with sequelae due to toxoplasmosis and Down syndrome (about 1000 and 4000 cases, respectively), which are diseases that are better known by women [59].…”

“…Washing hands after changing a baby's dirty nappy seems to be the most common preventive measure known and applied by the women interviewed to prevent possible CMV contamination. Rates of knowledge of hygiene measures, such as not sharing the same drinking glass, spoon, or fork with a child under five years of age, as well as not kissing on the lips and avoiding contact with nasal secretions or tears (when assessed), rank about the same in the studies analyzed, although with wide variations between studies [45,48,53,56,57,64]. It should be noted, however, that half of the studies that analyzed these different variables reported an overall knowledge rate of less than or equal to 50% [48,53,64].…”

“…Once the women had been informed of the hygiene practices to be applied, they reported an ease of application ranging from 65% to 98% regarding washing hands after changing diapers, avoiding sharing cutlery or food, and wiping runny noses or tears [45,48,49,53,54,56,57]. Ease of implementation of the preventive measure regarding not kissing infants on the lips appeared to be more difficult for the respondents to put into practice [55].…”