Human Cytomegalovirus Infection Is Detected Frequently in Stillbirths and Is Associated With Fetal Thrombotic Vasculopathy

Iwasenko, Jenna M.; Howard, Jonathan; Arbuckle, Susan; Graf, Nicole; Hall, Beverly A.; Craig, Maria E.; Rawlinson, William D.

doi:10.1093/infdis/jir121

Cited by 108 publications

(90 citation statements)

References 39 publications

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“…CMV is known to infect placental tissues, but it is not known whether CMVdriven placental inflammation commonly triggers preterm labor, resulting in a correspondingly high incidence of congenital infection in preterm infants. 18 CMV-mediated hearing loss might be exacerbated by the ototoxic antibiotics and diuretics frequently used in intensive care. CMV-mediated thrombocytopenia and neutropenia might be expected to increase rates of IVH and sepsis, respectively.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Impact of CMV Infection in Very Low Birth Weight Infants

2014

PEDIATRICS

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Section: Discussionmentioning

confidence: 99%

Incidence and Impact of CMV Infection in Very Low Birth Weight Infants

2014

PEDIATRICS

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“…34 However, increasing evidence indicates that fetal injury can result from indirect effects through placental infection and placental dysfunction. 27,[35][36][37] CMV is now the leading nongenetic cause of congenital malformation in developed countries. 13 Despite this, the extent of the problem with cCMV infection is largely unrecognized by mothers, fathers, obstetricians, midwives, paediatricians, medical students and other clinicians.…”

Section: Congenital CMV Transmission and Diseasementioning

confidence: 99%

Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention

et al. 2014

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Cytomegalovirus is the most common congenital infection causing serious disease in infants. It is the leading infectious cause of sensorineural hearing loss and neurodevelopmental disability in developed countries. Despite the clinical importance of congenital cytomegalovirus, surveys show there is limited awareness and knowledge in the medical and general community about congenital cytomegalovirus infection. This article reviews the clinical features, global epidemiology, transmission and risk factors for cytomegalovirus infections. It also highlights several major advances made in recent years in the diagnosis and prevention of cytomegalovirus infection during pregnancy. Although research is ongoing, no therapy is currently proven to prevent or treat maternal, fetal or neonatal cytomegalovirus infection. Education of women regarding hygiene measures can help prevent cytomegalovirus infection and are currently the best strategy to prevent congenital cytomegalovirus disease.

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“…There is emerging evidence that viruses cause some stillbirths. Iwasenko et al reported that the detection of CMV DNA in 15 % of fetal tissue or placenta from 130 stillbirths [9].…”

Section: Pathogenesis Of Congenital CMV Infectionmentioning

confidence: 99%

CMV Infection and Pregnancy

Tung

et al. 2012

Curr Obstet Gynecol Rep

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Cytomegalovirus (CMV) occurs in 0.2 % to 2.2 % of all live births and is the most common cause of intrauterine infection and the leading infectious cause of sensorineural hearing loss and mental retardation. This article reviews literature that relate to the pathogenesis, diagnosis, and treatment of this disease for pregnant women and their fetus. Primary maternal CMV infection during pregnancy has a much higher rate of mother-to-fetus transmission and causes symptoms at birth and long-term disability than nonprimary infection. In addition, some research has shown that children with congenital CMV infection following first-trimester maternal infection are more likely to have severe sequelae. The prenatal diagnosis of fetal CMV infection includes serological testing (IgM detection and IgG avidity assay), amniocentesis, and ultrasound examination. The combination of the presence of CMV IgM antibodies and low CMV IgG avidity, along with maternal or fetal symptoms is used for the diagnosis of a primary maternal infection. Amniocentesis should be complemented until approximately 20-21 weeks of gestation to increase the sensitivity. Because ultrasound abnormalities are only found in less than 25 % of infected fetuses, ultrasound is as a relatively poor predictor of symptomatic congenital infection. CMV hyperimmunoglobulin also may be considered when the pregnant women are confirmed as primary CMV infection with low IgG avidity and amniotic fluid is found to contain CMV or CMV DNA. There is no consensus on the benefit of prenatal administration of ganciclovir into the umbilical vein.

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Human Cytomegalovirus Infection Is Detected Frequently in Stillbirths and Is Associated With Fetal Thrombotic Vasculopathy

Cited by 108 publications

References 39 publications

Incidence and Impact of CMV Infection in Very Low Birth Weight Infants

Incidence and Impact of CMV Infection in Very Low Birth Weight Infants

Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention

CMV Infection and Pregnancy

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