Clinical factor associated with congenital cytomegalovirus infection in pregnant women with non-primary infection

Yamada, Hideto; Tanimura, Kenji; Tairaku, Shinya; Morioka, Ichiro; Deguchi, Masashi; Morizane, Mayumi; Nagamata, Satoshi; Ozaki, Kana; Ebina, Yasuhiko; Minematsu, Toshio

doi:10.1016/j.jiac.2018.04.010

Cited by 20 publications

(22 citation statements)

References 23 publications

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“…There is still uncertainty about whether symptoms can be addressed as reliable indicators of vertical transmission or disease severity [59][60][61]. Other infections that lead to congenital malformation, such as cytomegalovirus, also have a high number of asymptomatic cases, but, when present, symptoms might indicate an adverse outcome [62].…”

Section: Discussionmentioning

confidence: 99%

Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis

et al. 2020

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Background: Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection. Methods: We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors. Results: We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/ fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant's sexmales compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurredinfection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77. Conclusion: Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses.

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Section: Discussionmentioning

confidence: 99%

Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis

et al. 2020

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“…Furthermore, the frequency of changes in the decidua was higher in placentas from mothers with non-primary CMV infections than from those with primary infections. Recently, we reported that threatened premature delivery was associated with the occurrence of congenital CMV infections in pregnant women with non-primary CMV infections, the pathophysiology of which may be closely associated with CMV reactivation during pregnancy [21]. Threatened premature delivery may reflect the inflammatory conditions in which CMV is reactivated; alternatively, it may cause CMV reactivation in pregnant women.…”

Section: Fgrmentioning

confidence: 99%

Histopathological analysis of placentas with congenital cytomegalovirus infection

et al. 2019

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Introduction: Cytomegalovirus (CMV) infection is the most common cause of congenital viral infections in humans. The unusual structure of the placenta plays a pivotal role in CMV transmission from mothers to fetuses. The aim of this study was to evaluate the histopathological findings of placentas with congenital CMV infections. Methods: We obtained placental specimens from 35 women who had newborns with congenital CMV infections. Placental specimens, extraplacental membranes, and umbilical cords were stained with hematoxylin and eosin, and subjected to immunohistochemical analysis. We evaluated the localization of CMV-infected cells and other histological parameters. Results: Thirty (86%) of the 35 placentas tested positive for CMV-infected cell proteins by immunohistochemistry. A majority of CMV-positive cells were present in fibroblasts and endothelial cells in the villi. The number of CMV-infected cells was inversely correlated to gestational age at delivery. The frequency of chronic villitis (65% vs. 11%; p<0.01) and changes of the villi (38% vs. 0%; p<0.05) in the placentas from mothers with symptomatic congenital CMV infections was higher than those observed in samples from mothers with asymptomatic congenital infections. The frequency of changes of the decidua (43% vs. 5%; p<0.01) in the placentas from mothers with non-primary CMV infections was higher than those from mothers with primary infections. Discussion: Chronic villitis and changes of the villi were associated with symptomatic congenital CMV infections. The changes of the decidua were associated with congenital CMV infections, in mothers with non-primary CMV infections.

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“…There is still uncertainty if the symptoms can be addressed as reliable indicators of vertical transmission or disease severity [59][60][61]. Other infections that lead to congenital malformation, such as cytomegalovirus, also have a high number of asymptomatic cases, but, when present, symptoms might indicate an adverse outcome [62].…”

Section: Discussionmentioning

confidence: 99%

Another piece on the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.

Gallo

Martínez-Cajas

Peixoto

et al. 2020

Preprint

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Background: Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the foetus, the risk factors associated to this tragic disorder remain unclear. We conducted a systematic review and meta-analysis toto assess risk factors associated with the incidence of microcephaly in congenital ZIKV infection. Methods: We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from authors of the studies included in this review to calculate summary estimates and conduct meta-analysis of the most prevalent factors. Results: We screened 4,106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6,154 children/foetuses were enrolled; of those, 1,120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in foetuses/ children. Half of the studies provided primary data. Two out of eleven factors of interest were associated with microcephaly: infant’s sex – males presented a higher risk of microcephaly compared to females (RR 1.30, 95% CI 1.14, 1.49); and the stage of pregnancy when infection occurred - infection in the first trimester of pregnancy had a higher risk of microcephaly (RR 1.41, 95% CI 1.09 to 1.82), compared to infection at other stages of pregnancy. Conclusion: Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when Zika virus infection occurs. Continued surveillance of ZIKV during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected foetuses.

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Clinical factor associated with congenital cytomegalovirus infection in pregnant women with non-primary infection

Cited by 20 publications

References 23 publications

Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis

Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis

Histopathological analysis of placentas with congenital cytomegalovirus infection

Another piece on the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.

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