A prospective study of cytomegalovirus infection in pregnancy I laboratory evidence of congenital infection following maternal primary and reactivated infection

Grant, S S; Edmond, Elizabeth; Syme, James

doi:10.1016/s0163-4453(81)92211-8

Cited by 58 publications

(17 citation statements)

References 16 publications

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“…The birth/fetal prevalence in women with primary infections ranged from 14.2% (9.4-20.9%) [41] to 52.4% (29.8-74.3%) [28] in 19 study groups ( Figure 4A). The combined birth/fetal prevalence in these study groups was 32.3% (29.8-34.9%).…”

Section: Epidemiology Of Congenital CMV Infection Epidemiology Of Conmentioning

confidence: 99%

Review and meta‐analysis of the epidemiology of congenital cytomegalovirus (CMV) infection

Kenneson

Cannon

2007

Reviews in Medical Virology

1,482

1,229

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We reviewed studies that reported results of systematic cytomegalovirus (CMV) screening on fetuses and/or live-born infants. The overall birth prevalence of congenital CMV infection was 0.64%, but varied considerably among different study populations. About 11% of live-born infants with congenital CMV infection were symptomatic, but the inter-study differences in definitions of symptomatic cases limit the interpretation of these data. Non-white race, low socioeconomic status (SES), premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection. Birth prevalence increased with maternal CMV seroprevalence. Maternal seroprevalence accounted for 29% of the variance in birth prevalence between study populations. Maternal seroprevalence and birth prevalence were both higher in study populations that were ascertained at birth rather than in the prenatal period. Thus, timing of ascertainment should be considered when interpreting birth prevalence estimates. Birth prevalence was inversely correlated with mean maternal age, but this relationship was not significant when controlling for maternal seroprevalence. The rate of transmission to infants born to mothers who had a primary infection or a recurrent infection during pregnancy was 32% and 1.4%, respectively. Possible maternal primary infections (i.e. seropositive mother with CMV IgM) resulted in congenital infections about 20% of the time, but are likely to represent a mixture of primary and recurrent infections. In summary, CMV is a common congenital infection worldwide that can lead to permanent disabilities. There is an urgent need for interventions that can reduce the substantial burden of this often overlooked disease.

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Section: Epidemiology Of Congenital CMV Infection Epidemiology Of Conmentioning

confidence: 99%

Review and meta‐analysis of the epidemiology of congenital cytomegalovirus (CMV) infection

Kenneson

Cannon

2007

Reviews in Medical Virology

1,482

1,229

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“…To reduce sampling variability, we only included countries that had at least 500 women tested. Studies were from Australia [44], Belgium [45][46][47], Brazil [48,49], Canada [25,[50][51][52], Chile [53,54], England [23,[55][56][57][58][59][60][61], Finland [62], France [63][64][65][66], Germany [67,68], Ghana [69], India [70][71][72], Israel [73,74], Italy [75][76][77], Japan [35,37,78,79], Scotland [80], South Africa [27], Spain [43], Sweden [38], Taiwan [39,81], Turkey [82][83][84] and the United States …”

Section: Race/ethnicitymentioning

confidence: 99%

Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection

Cannon¹,

Schmid²,

Hyde³

2010

Reviews in Medical Virology

1,283

928

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Cytomegalovirus establishes a lifelong latent infection following primary infection that can periodically reactivate with shedding of infectious virus. Primary infection, reactivation and reinfection during pregnancy can all lead to in utero transmission to the developing fetus. Congenital CMV infections are a major cause of permanent hearing loss and neurological impairment. In this literature review, we found that CMV infection was relatively common among women of reproductive age, with seroprevalence ranging from 45 to 100%. CMV seroprevalence tended to be highest in South America, Africa and Asia and lowest in Western Europe and United States. Within the United States, CMV seroprevalence showed substantial geographic variation as well, differing by as much as 30 percentage points between states, though differences might be explained by variation in the types of populations sampled. Worldwide, seroprevalence among non-whites tended to be 20-30 percentage points higher than that of whites (summary prevalence ratio (PR) = 1.59, 95% confidence interval (CI) = 1.57-1.61). Females generally had higher seroprevalences than males, although in most studies the differences were small (summary PR = 1.13, 95% CI = 1.11-1.14). Persons of lower socioeconomic status were more likely to be CMV seropositive (summary PR = 1.33, 95% CI = 1.32-1.35). Despite high seroprevalences in some populations, a substantial percentage of women of reproductive age are CMV seronegative and thus at risk of primary CMV infection during pregnancy. Future vaccine or educational campaigns to prevent primary infection in pregnant women may need to be tailored to suit the needs of different populations.

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“…The number of women undergoing a primary infection in each study is shown in parentheses. (See references 43,54,55,56,71,137,143,184,209,210,211,212,213, and 214.) …”

Section: Impact Of the Hiv Epidemic On Congenital CMVmentioning

confidence: 99%

The “Silent” Global Burden of Congenital Cytomegalovirus

et al. 2013

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SUMMARYHuman cytomegalovirus (CMV) is a leading cause of congenital infections worldwide. In the developed world, following the virtual elimination of circulating rubella, it is the commonest nongenetic cause of childhood hearing loss and an important cause of neurodevelopmental delay. The seroprevalence of CMV in adults and the incidence of congenital CMV infection are highest in developing countries (1 to 5% of births) and are most likely driven by nonprimary maternal infections. However, reliable estimates of prevalence and outcome from developing countries are not available. This is largely due to the dogma that maternal preexisting seroimmunity virtually eliminates the risk for sequelae. However, recent data demonstrating similar rates of sequelae, especially hearing loss, following primary and nonprimary maternal infection have underscored the importance of congenital CMV infection in resource-poor settings. Although a significant proportion of congenital CMV infections are attributable to maternal primary infection in well-resourced settings, the absence of specific interventions for seronegative mothers and uncertainty about fetal prognosis have discouraged routine maternal antibody screening. Despite these challenges, encouraging results from prototype vaccines have been reported, and the first randomized phase III trials of prenatal interventions and prolonged postnatal antiviral therapy are under way. Successful implementation of strategies to prevent or reduce the burden of congenital CMV infection will require heightened global awareness among clinicians and the general population. In this review, we highlight the global epidemiology of congenital CMV and the implications of growing knowledge in areas of prevention, diagnosis, prognosis, and management for both low (50 to 70%)- and high (>70%)-seroprevalence settings.

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A prospective study of cytomegalovirus infection in pregnancy I laboratory evidence of congenital infection following maternal primary and reactivated infection

Cited by 58 publications

References 16 publications

Review and meta‐analysis of the epidemiology of congenital cytomegalovirus (CMV) infection

Review and meta‐analysis of the epidemiology of congenital cytomegalovirus (CMV) infection

Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection

The “Silent” Global Burden of Congenital Cytomegalovirus

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