Frequency, timing and risk factors for primary maternal cytomegalovirus infection during pregnancy in Quebec

Abstract

Introduction Maternal Cytomegalovirus (CMV) infection in the first trimester (T1) of pregnancy is a public health concern, as it increases the risk of severe neurodevelopmental outcomes associated with congenital infection compared to infections occurring later during pregnancy. Objectives To determine CMV seroprevalence in T1 of pregnancy, its trend, risk factors and the incidence rate of primary infection during pregnancy. Methods Using the biobank of the prospective cohort “Grossesse en Santé de Québec” collected between April 2005 and March 2010 at the Québec-Laval Hospital, Québec, Canada, maternal CMV serology was determined using Abbott Architect Chemiluminescence microparticle immunoassays for immunoglobulin G(IgG), immunoglobulin M(IgM) titration and IgG avidity testing. Changepoint detection analysis was used to assess temporal trends. Risk factors associated with seropositivity were determined by multivariable logistic regression. Results CMV seroprevalence in T1 of pregnancy was 23.4% (965/4111, 95% CI, 22.1–24.7%). The incidence rate for CMV primary infection during pregnancy was 1.8 (95% CI, 1.2–2.6) per 100 person-years. No changepoint was identified in the maternal CMV-seroprevalence trend. Multivariable analyses showed that T1 maternal CMV seropositivity was associated with having one child OR 1.3 (95% CI, 1.10–1.73) or two or more children OR 1.5 (95%CI, 1.1–2.1), ethnicity other than Caucasian OR 2.1 (95% CI, 1.1–3.8) and country of birth other than Canada and the USA OR 2.8 (95% CI, 1.5–4.9). Conclusions In this cohort, maternal seroprevalence in T1 of pregnancy and seroconversion rate were low. This information and identified risk factors could help guide the development and implementation of preventive actions and evidence-based health policies to prevent CMV infection during pregnancy.

An Overview of Cytomegalovirus Infection in Pregnancy

“…High-avidity IgG during the first trimester is related to past infection, whereas low-avidity antibodies, especially with long persistence, are associated with IgM and can lead to a false diagnosis of primary maternal infection. Additionally, the rapid increase in the avidity of IgG is associated with a higher risk of intrapartum fetal infection [ 32 ].…”

Sero-prevalence and risk factors for cytomegalovirus infection among pregnant women in a teaching hospital in Ogun state, Nigeria

“…Lower rates were however found in other nations. For example 59.9% (IgG) and 1.3% (IgM) in Norway (23); 30.4% (IgG) in Ireland (24); 51.5% (IgG) in France (25); 23.47% (IgG) and 1% (IgM) in Canada (26); and 62.4% and 2.2% in Poland ( 27). The highest rates of infection (56.52%) in this study were among women with a BSc or BA degree.…”

D-Xylose, a Stimulator of Heparan Sulfate Biosynthesis, Exhibits Antiviral Properties Against SARS-CoV-2, ZIKV, HCMV and HIV-1 NL4-3 In Vitro

“…For B's size, let us use X to indicate pregnant women who have a primary infection during pregnancy and Y to indicate pregnant women passing CMV to the foetus during pregnancy. B = X Y, P(X) = 2% [30] and P(Y|X) = prevalence of congenital CMV infection following CMV primary infection in pregnancy = 35% [31], according to the conditional probability formula: P(B) = P(X Y) = P(Y|X) × P(X) = 2% × 35% = 0.7%. Thus, populations A and B are almost of identical in size.…”