Maternal Immunity and Prevention of Congenital Cytomegalovirus Infection

Abstract

Context Vaccine development to prevent congenital cytomegalovirus (CMV) infection has been impeded by the uncertainty over whether maternal immunity protects the fetus. Objective To determine whether the presence of maternal antibodies to CMV significantly reduces the risk of congenital CMV infection in future pregnancies. Design, Setting, and Participants Cohort study of 3461 multiparous women from a population with a high rate of congenital CMV infection who delivered newborns screened for congenital CMV infection between 1993 and 1998, and whose cord serum specimen from a previous delivery could be retrieved and tested for antibody to CMV. Main Outcome Measure Congenital CMV infection according to maternal immune status, age, race, parity, and socioeconomic status. Results Of 604 newborns born to initially seronegative mothers, congenital CMV infection occurred in 18 (3.0%). In contrast, of 2857 newborns born to immune mothers, congenital CMV infection occurred in 29 (1.0%) Two factors, preconception maternal immunity (adjusted risk ratio, 0.31; 95% confidence interval, 0.17-0.58) and maternal age of 25 years or older (adjusted risk ratio, 0.19; 95% confidence interval, 0.07-0.49), were highly protective against congenital CMV infection. No other factors were associated with a reduction in the risk of congenital CMV infection. Conclusion Naturally acquired immunity results in a 69% reduction in the risk of congenital CMV infection in future pregnancies.

Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population‐based study

“…Children within the cCMV group were more likely to be born to younger mothers. This finding is consistent with previous studies [23][24][25] which found that young maternal age is a risk factor for cCMV infection. These findings suggest that younger mothers may be a potential target group for public health initiatives to reduce or prevent vertical transmission of cCMV.…”

Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population‐based study

“…Children within the cCMV group were more likely to be born to younger mothers. This finding is consistent with previous studies [23][24][25] which found that young maternal age is a risk factor for cCMV infection. These findings suggest that younger mothers may be a potential target group for public health initiatives to reduce or prevent vertical transmission of cCMV.…”

Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

“…Our results are consistent with previous reports on risk factors for CMV, including maternal HIV seropositivity ( Mostad et al, 1999 ; Pathirana et al, 2019 ) and younger maternal age ( Fowler et al, 2003 ; Preece et al, 1986 ). Furthermore, neonates who were positive for CMV had significantly lower weight-for-age z -score despite being older than the neonates who were negative for CMV.…”

Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe

“…The presence of CMV-specific IgG antibodies in the serum—which indicates a prior or current CMV infection—has been correlated previously with several epidemiological factors, including age, gravidity, parity, and socioeconomic status. [ 3 , 4 , 6 , 21 ] Most of these previous findings are consistent with our own findings. However, we found an inverse correlation between maternal age and seropositivity, which is in contrast to other published findings.…”

Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population‐based study

“…Children within the cCMV group were more likely to be born to younger mothers. This finding is consistent with previous studies [23][24][25] which found that young maternal age is a risk factor for cCMV infection. These findings suggest that younger mothers may be a potential target group for public health initiatives to reduce or prevent vertical transmission of cCMV.…”

Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

“…Our results are consistent with previous reports on risk factors for CMV, including maternal HIV seropositivity ( Mostad et al, 1999 ; Pathirana et al, 2019 ) and younger maternal age ( Fowler et al, 2003 ; Preece et al, 1986 ). Furthermore, neonates who were positive for CMV had significantly lower weight-for-age z -score despite being older than the neonates who were negative for CMV.…”

Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe

“…The presence of CMV-specific IgG antibodies in the serum—which indicates a prior or current CMV infection—has been correlated previously with several epidemiological factors, including age, gravidity, parity, and socioeconomic status. [ 3 , 4 , 6 , 21 ] Most of these previous findings are consistent with our own findings. However, we found an inverse correlation between maternal age and seropositivity, which is in contrast to other published findings.…”

Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population‐based study

“…Children within the cCMV group were more likely to be born to younger mothers. This finding is consistent with previous studies [23][24][25] which found that young maternal age is a risk factor for cCMV infection. These findings suggest that younger mothers may be a potential target group for public health initiatives to reduce or prevent vertical transmission of cCMV.…”

Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

“…Our results are consistent with previous reports on risk factors for CMV, including maternal HIV seropositivity ( Mostad et al, 1999 ; Pathirana et al, 2019 ) and younger maternal age ( Fowler et al, 2003 ; Preece et al, 1986 ). Furthermore, neonates who were positive for CMV had significantly lower weight-for-age z -score despite being older than the neonates who were negative for CMV.…”

Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe

“…The presence of CMV-specific IgG antibodies in the serum—which indicates a prior or current CMV infection—has been correlated previously with several epidemiological factors, including age, gravidity, parity, and socioeconomic status. [ 3 , 4 , 6 , 21 ] Most of these previous findings are consistent with our own findings. However, we found an inverse correlation between maternal age and seropositivity, which is in contrast to other published findings.…”