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

Song, Xinli; Li, Qiongxuan; Diao, Jingyi; Li, Jinqi; Li, Yihuan; Zhang, Senmao; Chen, Letao; Wei, Jianhui; Shu, Jing; Liu, Yiping; Sun, Mengting; Sheng, Xiaoqi; Wang, Tingting; Qin, Jiabi

doi:10.3389/fped.2022.803568

Cited by 5 publications

(2 citation statements)

References 44 publications

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“…6,7 Symptomatic cCMV disease has also been implicated in heightened risk of death in utero, the neonatal period (birth through 4 weeks of age), infancy (the first year of life) and childhood. 2,3,[8][9][10][11] For instance, approximately 15% of stillbirths examined in Australian and Greek studies had evidence of CMV infection and associated placental abnormalities, 3,8,12 Regarding post-neonatal deaths, an…”

Section: Introductionmentioning

confidence: 99%

Estimates of congenital cytomegalovirus‐attributable infant mortality in high‐income countries: A review

Grosse,

Fleming,

Pesch

et al. 2024

Reviews in Medical Virology

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As many as 5%–10% of infants with symptomatic congenital cytomegalovirus (cCMV) disease, or 0.4%–0.8% of all liveborn infants with cCMV infection, die in early infancy in high‐income countries. However, estimates are uncertain due to several potential biases that can result from data limitations and study designs. First, infants with cCMV infections who die prior to diagnosis, which usually occurs at 1–4 weeks after birth, may be excluded from both the count of deaths and the denominator of cCMV births, resulting in left truncation and immortal time biases. These ‘biases’ are features of the data and do not reflect bias on the part of researchers, but understanding the potential existence of threats to validity can help with interpretation of findings. Left truncation of infant deaths occurring prior to diagnosis of cCMV can result in understatement of the burden of infant deaths due to cCMV. Conversely, overestimation of infant deaths associated with symptomatic cCMV may occur in clinical case series owing to greater representation of relatively severely affected infants owing to ascertainment and referral biases. In this review, we summarise the characteristics of 26 studies that reported estimates of cCMV‐associated infant deaths, including potential biases or limitations to which those estimates may have been subject. We discuss study designs whose implementation might generate improved estimates of infant deaths attributable to cCMV. More complete estimates of the overall public health impact of cCMV could inform current and future screening, prevention, and vaccine research.

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Section: Introductionmentioning

confidence: 99%

Estimates of congenital cytomegalovirus‐attributable infant mortality in high‐income countries: A review

Grosse,

Fleming,

Pesch

et al. 2024

Reviews in Medical Virology

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“…TORCH infections during pregnancy are the leading cause of prenatal and infant morbidity and mortality in China [6,7]. This issue is perhaps nowhere more severe than in Guangdong, a province in southern China with the largest migrant population (52 million migrants in 2020, accounting for 41.3% of the whole population) [8].…”

Section: Introductionmentioning

confidence: 99%

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

Han²,

Xiong

et al. 2022

Preprint

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Background TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse’s migrant status on the TORCH epidemic among women of childbearing age. Methods Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15–49 years old) in Guangdong Province of China (2014–2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors. Results Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88–0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77–1.99), past CMV infection (aOR: 1.26, 1.25–1.28) and RV infection in natural ways (aOR: 1.05, 1.04–1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85–0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05–1.27) and RV infection (aOR: 1.33, 1.31–1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection. Conclusions This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse’s migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.

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Global efforts needed to address burden of preventable stillbirth

Khalil,

Samara,

Coutinho

et al. 2024

Ultrasound in Obstet & Gyne

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

Cited by 5 publications

References 44 publications

Estimates of congenital cytomegalovirus‐attributable infant mortality in high‐income countries: A review

Estimates of congenital cytomegalovirus‐attributable infant mortality in high‐income countries: A review

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

Global efforts needed to address burden of preventable stillbirth

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