Maternal type of CMV infection and sequelae in infants with congenital CMV: Systematic review and meta-analysis

Maltezou, Panagiota Georgia; Kourlaba, Georgia; Kourkouni, Εleni; Luck, Suzanne; Blázquez‐Gamero, Daniel; Ville, Y.; Lilleri, Daniele; Dimopoulou, Dimitra; Karalexi, Maria A.; Papaevangelou, Vassiliki

doi:10.1016/j.jcv.2020.104518

Cited by 47 publications

(42 citation statements)

References 38 publications

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“…Given that CMV screening tests are typically performed in early pregnancy rather than before conception, and that the serologic test was a screening test rather than a diagnostic test, the present study employed presumed maternal CMV infection rather than confirmed maternal CMV infection ( 18 – 20 ). The definition of presumed maternal primary CMV infection was based on the presence of CMV-specific low-avidity IgG and CMV-specific IgM in the first trimester of gestation ( 19 ). Furthermore, because IgG appeared later than IgM when primary infection occurred, pregnant women with CMV IgM but no IgG were asked to reexamine CMV-specific IgG 2–3 weeks later, and subsequently those with CMV-specific IgG in the paired samples were also considered primary CMV infection.…”

Section: Methodsmentioning

confidence: 99%

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Song

Diao

et al. 2022

Front. Pediatr.

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BackgroundGiven that the time lag between cytomegalovirus (CMV) screening and diagnosed testing, a better knowledge of the association between pregnant women with CMV screening test positive and stillbirth in an epidemiological perspective was required to assist people being counseled reframe their pregnancy and birth plans based on the magnitude of the risk.MethodsThis study recruited 44048 eligible pregnant women from March 13, 2013 to December 31, 2019. Serological tests including CMV-specific IgM and IgG, and IgG avidity index were used to screen for maternal CMV infection and were measured by automated chemiluminescence immunoassay. The association was assessed using the inverse probability of group-weighted multivariate-adjusted log-binomial models.ResultsA total of 540 infants ended with a stillbirth (12.3 per 1000 pregnancies), and 2472 pregnancies with maternal CMV infection were screened out (56.1 per 1000 pregnancies) among all eligible pregnancies. In the comparison analysis, 326 infants ended with a stillbirth (86.6 per 1000 pregnancies) in the maternal CMV infection group compared with 214 infants (7.8 per 1000 pregnancies) in the group where mothers were not infected with CMV (RR 12.17; 95% CI 9.43–15.71). After excluding the pregnancies of stillbirth with birth defects, a strong association between the two groups was still observed (RR 9.38; 95% CI 6.92–12.70).ConclusionOur findings quantified the risk of a woman having a baby with stillbirth if she had a positive serologic CMV screening test in her first trimester, and supported the value of using CMV serologic tests as part of regular testing in pregnant women.Trial registrationRegistered in Chinese Clinical Trial Registry Center; registration number, ChiCTR1800016635; registration date, 06/14/2018 (Retrospectively registered); URL of trial registry record, https://www.chictr.org.cn/showproj.aspx?proj=28300.

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Section: Methodsmentioning

confidence: 99%

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Song

Diao

et al. 2022

Front. Pediatr.

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“…Tanto la primoinfección como la infección no primaria pueden generar compromiso fetal profundo y secuelas a largo plazo, si estas ocurren principalmente durante el primer trimestre del embarazo 20,21 . Pese a que la transmisión vertical es mayor en el caso de la primoinfección materna, proporcionalmente el número de casos de infección congénita en poblaciones de alta seroprevalencia ocurre sobre todo por una infección materna no primaria.…”

Section: Seroprevalencia Materna Y Riesgo De Infección Fetalunclassified

Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

Izquierdo¹,

Sandoval²,

Abarzúa-Camus³

et al. 2024

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infección por citomegalovirus (CMV) en la mujer embarazada y el recién nacido. Esta guía aborda el manejo de la infección en el binomio, su enfrentamiento diagnóstico y terapéutico, orientado al equipo de salud que atiende a mujeres embarazadas y recién nacidos con infección por CMV en Chile. Considera la situación epidemiológica global y latinoamericana, con recomendaciones para la evaluación clínica y de laboratorio; establece criterios de diagnóstico, propone enfoques terapéuticos de acuerdo a la situación clínica, analiza las medidas de prevención y establece una propuesta nacional para el seguimiento de esta enfermedad. Se ha puesto especial énfasis en entregar, de forma práctica, y con la mayor evidencia posible, las recomendaciones para el manejo del binomio con infección por CMV.

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“…Among permanent sequelae , the most common are sensorineural hearing loss (SNHL), which is more frequent in symptomatic cCMV infections [ 10 ], as well as permanent intellectual and physical disabilities [ 11 ]. While for some time pre-pregnancy maternal immunity was considered to be associated with a lower rate of severe permanent sequelae , other reports have shown that the frequency was comparable in infants with cCMV born to mothers with PI or NPI [ 7 , 12 , 13 , 14 ].…”

Section: Epidemiologymentioning

confidence: 99%

Congenital Human Cytomegalovirus Infection: A Narrative Review of Maternal Immune Response and Diagnosis in View of the Development of a Vaccine and Prevention of Primary and Non-Primary Infections in Pregnancy

et al. 2021

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Congenital cytomegalovirus infection (cCMV) may affect about 1% of all newborns all over the world as a result of either a primary or recurrent human cytomegalovirus (HCMV) infection. While about 90% of infants affected by cCMV are asymptomatic at birth, the remaining 10% are symptomatic often with neurodevelopmental impairment and sensorineural hearing loss. In view of identifying the best approach to vaccine prevention of cCMV, this review will examine the most important steps made in the study of the immune response to, and diagnosis of, HCMV infection. The maternal immune response and immune correlates of protection are being partially identified with a partial contribution given by our laboratory. The diagnosis of primary infection is often difficult to achieve in the first three months of pregnancy, which is the time primarily involved in virus transmission to the fetus in association with the most severe symptoms and sequelae. Prevention of cCMV is anticipated by prevention of primary infection in early pregnancy by means of different measures, such as (i) behavioral-educational measures, (ii) immunoglobulin administration, (iii) antiviral treatment with valaciclovir. However, the most promising approach to cCMV prevention appears to be the development of a non-living vaccine, including at least three viral antigens: gB, pentamer complex gHgLpUL128L, and pp65, which have been shown to be able to stimulate both the humoral and the cellular arms of the maternal immune response. Primary HCMV infection may be managed in pregnancy by counseling of the couples involved by a team of specialists that includes virologists, obstetricians, infectivologists and neonatologists.

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Maternal type of CMV infection and sequelae in infants with congenital CMV: Systematic review and meta-analysis

Cited by 47 publications

References 38 publications

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

Congenital Human Cytomegalovirus Infection: A Narrative Review of Maternal Immune Response and Diagnosis in View of the Development of a Vaccine and Prevention of Primary and Non-Primary Infections in Pregnancy

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