Knowledge of Human Cytomegalovirus Infection and Prevention in Pregnant Women: A Baseline, Operational Survey

Mazzitelli, Maria; Micieli, Mariella; Votino, Carmela; Visconti, Federica; Quaresima, Paola; Strazzulla, Alessio; Torti, Carlo; Zullo, Fulvio

doi:10.1155/2017/5495927

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…National guidelines recommend monitoring pregnant women for Toxoplasmosis and Rubella although Cyto-megalovirus is routinely checked as well. A great attention is given to prevent infections during pregnancy; indeed, our study population has proven the non-significant role that these conditions have on stillbirth rate [31]. Thirty per cent of cases occurred at term, (≥ 37 weeks of gestation).…”

Section: Discussionmentioning

confidence: 86%

Stillbirth, potentially preventable cases: an Italian retrospective study

Quaresima¹,

Saccone²,

Morelli³

et al. 2022

Ital J Gynaecol Obstet

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Objective. The reduction in the global burden of child mortality is one of the Millennium developmental goals of the World of Health Organization (WHO). Understanding the pathophysiology underlying every single stillbirth case will allow the achievement of the WHO goal by implementing specific interventions. The aim of the study was to examine stillbirth cases occurred from 2012 to 2020 in a single tertiary obstetric care unit in Italy. Materials and Methods. Stillbirths were identified by the hospital electronic archive system. Pre-pregnancy/pregnancy related risk factors and post-mortem examinations were recorded. Results. A total of 53 stillbirth cases out of 19115 deliveries occurred in the study period (overall 2.77 cases every 1000 live births). The most frequent pre-pregnancy risk factors associated to events were maternal overweight/obesity (50.9%), nulliparity (49%), inherited coagulation disorders (26.4%) and sub clinical hypothyroidism (11.3%). The most common pregnancy related risk factors were growth restriction (56.6%), gestational diabetes mellitus (15%), hypertensive disorders of pregnancy (9.4%) and cord knot (7.5%). Among the 53 cases, 12 would have been potentially preventable with a better antenatal care (22.6%), seven of these occurred at a gestational age equal or more that 39 weeks of gestation. A significant drop in stillbirth incidence has been documented from 2019 (3.17 cases every 1000 live births before 2019 versus 1.19 cases every 1000 live births from 2019, respectively (p = 0.039)), when, a protocol for induction of labor specific for each pre-pregnancy and pregnancy related risk factors has been introduced in clinical practice. Conclusions. A significant proportion of stillbirth cases are potentially preventable with a better antenatal care.

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Section: Discussionmentioning

confidence: 86%

Stillbirth, potentially preventable cases: an Italian retrospective study

Quaresima¹,

Saccone²,

Morelli³

et al. 2022

Ital J Gynaecol Obstet

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“…Although a vaccine is not actually available to avoid HIV-primary infection, prevention through hygienic measures represents the only way to prevent infections. These mainly include avoiding contact with children and washing hands thoroughly after this kind of contact [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Fetal Growth Restriction and Clinical Parameters of Newborns from HIV-Infected Romanian Women

et al. 2023

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Background and Objectives: The present study assessed the fetal growth restriction and clinical parameters of both human immunodeficiency virus (HIV)-negative and HIV-positive newborns from HIV-infected mothers in two HIV-acquired immunodeficiency syndrome regional centers (RCs) in Constanta and Craiova, Romania, in order to evaluate the adverse birth-related outcomes. Materials and Methods: These represent a retrospective study conducted between 2008 and 2019, in which 408 pregnant HIV-positive women, 244 from Constanta RC and 164 from Craiova RC, were eligible to participate in the study. Consecutive singleton pregnancies delivered beyond 24 weeks of pregnancy were included. Growth restriction in newborns was defined as the birth weight (BW) being less than the third percentile, or three out of the following: BW < 10th percentile; head circumference (HC) < 10th percentile; birth length (BL) < 10th percentile; prenatal diagnosis of fetal growth restriction; and maternal pregnancy information. Of the 244 newborns delivered in Constanta, RC, 17 were HIV-positive, while in Craiova, RC, of the 164 newborns, 9 were HIV-positive. All HIV-positive women were on combined antiretroviral therapy (cART) during pregnancy, similar to all HIV-positive newborns who received ARTs for the first six weeks. We search for the influence of anthropometrical parameters (i.e., HC, BL, and BW), as well as clinical parameters (i.e., newborn sex and Apgar score) for both HIV-negative and HIV-positive newborns, along with the survival rate of HIV-positive newborns. Results: There were no differences in the sex of the newborns within either group, with more than 50% being boys. Similarly, the Apgar score did not show any statistically significant values between the two groups (i.e., p = 0.544 for HIV-positive newborns vs. p = 0.108 for HIV-negative newborns). Interestingly, our results showed that in Craiova, RC, there was a chance of 2.16 to find an HIV-negative newborn with an HC < 10th percentile and a 2.54 chance to find an HIV-negative newborn with a BL < 10th percentile compared to Constanta, RC, without any significant differences. On the contrary, Constanta, RC, represented a higher risk of death (i.e., 3.049 times, p = 0.0470) for HIV-positive newborns compared to Craiova, RC. Conclusions: Our results support the idea that follow-up of fetal growth restriction should be part of postnatal care in this high-risk population to improve adverse birth-related outcomes.

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“…Nevertheless, as we assume that PCR in whole blood is more sensitive than PCR in serum, in the case of isolated IgM and negative PCR in serum, it would be wise to perform CMV PCR on a whole blood sample collected as soon as possible. Our study focuses on the importance of early CMV PI diagnosis in order to treat to prevent CMV infection, but we obviously highlight the crucial importance of avoiding and preventing the maternal infection, which requires knowledge in pregnant women [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Contribution of Serum Cytomegalovirus PCR to Diagnosis of Early CMV Primary Infection in Pregnant Women

Périllaud-Dubois

Bouthry

Mouna

et al. 2022

Viruses

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(1) Background: What is the role of serum CMV PCR in the diagnosis of recent primary infection (PI) in pregnant women when IgG avidity is uninformative? (2) Methods: Retrospective cohort study to compare serum versus whole blood CMV PCR. (a) Qualitative assessment: CMV PCR was performed on 123 serum samples and 74 whole blood samples collected from 132 pregnant women with recent CMV PI. PCR positivity rate was used to calculate sensitivity in serum and whole blood. (b) Quantitative assessment: CMV PCR was performed on 72 paired samples of serum and whole blood collected on the same day from 57 patients. (3) Results: In pregnant women, PCR positivity rate was 89% for serum samples versus 100% in whole blood in the case of very recent PI (<15 days), but only 27% in serum versus 68% in whole blood for PI occurring from 6 weeks to 3 months before. Comparing CMV viral loads between serum and whole blood, we determined the limit of CMV DNA detection in serum as 3 log copies/mL (whole blood equivalent). (4) Conclusions: Serum CMV PCR is reliable in confirming PI in cases when only IgM is detected. It is therefore a valuable tool in introducing valaciclovir treatment as early as possible to prevent mother-to-child CMV transmission.

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Knowledge of Human Cytomegalovirus Infection and Prevention in Pregnant Women: A Baseline, Operational Survey

Cited by 15 publications

References 7 publications

Stillbirth, potentially preventable cases: an Italian retrospective study

Stillbirth, potentially preventable cases: an Italian retrospective study

Fetal Growth Restriction and Clinical Parameters of Newborns from HIV-Infected Romanian Women

Contribution of Serum Cytomegalovirus PCR to Diagnosis of Early CMV Primary Infection in Pregnant Women

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