Maternal IgM antibody status in confirmed fetal cytomegalovirus infection detected by sonographic signs

Goncé, Anna; Marcos, M.Á.; Borrell, Antoni; López, Marta; Nadal, Alfons; Figueras, F.; Gratacós, E.

doi:10.1002/pd.3907

Cited by 16 publications

(16 citation statements)

References 28 publications

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“…Of these, 37 pairs were concordant (both positive) for CMV, 6 pairs were concordant (both negative), and 38 pairs were discordant. Removing the 4 overlapping pairs from the 3 articles labeled (Leisnard et al, 2000;Goncéet al, 2012;Lidehäll et al, 2013), Table 2…”

Section: Resultsmentioning

confidence: 99%

“…With small numbers, these examinations are considered exploratory. Factors included: sex (possible for DZ twin pairs; Picone et al., 2005 ; Dinkar and Singh, 2020 ); whether the maternal infection was primary or non-primary ( Goncé et al., 2012 ); the gestational age at which the maternal infection occurred ( Samedi et al., 2016 ); prematurity ( Shmueli et al., 2017 ); and fetal growth discordance ( Ahlfors et al., 1988 ). We also examined CMV infection concordance according to whether a MZ twin pair was monochorionic or dichorionic ( Ahlfors et al., 1988 ).…”

Section: Methodsmentioning

confidence: 99%

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Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

Hutton

Rowan

2021

Front. Cell. Infect. Microbiol.

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ObjectiveThe objectives are to estimate the vertical transmission rate in twins relative to singleton pregnancies, to evaluate whether discordance within twin pairs is rare, and to characterize concordance within monozygotic and dizygotic twin pairs in relation to hereditability.MethodsWe first sought to estimate the vertical transmission rate of congenital CMV infection in twins by gathering cohort-based studies of congenital CMV in which vertical transmission in both singleton and twin pregnancies was reported. This also allowed us to compare singleton and twin infection rates. From the above studies and other large cohorts of congenitally infected infants, the percentage of discordantly infected twin pairs determined whether this is a rare phenomenon. Theorizing discordance is not rare, we then analyzed data from cases with twin outcomes for congenital CMV infection, according to whether the twins were monozygotic or dizygotic, and calculated their corresponding concordance rates to estimate the broad-sense heritability. Lastly, we described other factors that might affect vertical transmission.ResultsFrom five articles following at-risk pregnancies, the rate of vertical transmission in twin pregnancies is 58.7% (95% CI 43.3-72.3%) whereas in singleton pregnancies it is 31.4% (95% CI: 29.0-34.0%) p = 0.0002. Of ten studies of larger cohorts of infants with congenital CMV infection, 21 of 42 twin pairs with at least one twin infected were discordant for congenital CMV (50.0%, 95% CI: 34.4–65.6%) indicating discordance of congenital CMV infection in twin pairs is not rare. Of 28 studies covering 37 twin pairs where at least one twin had congenital CMV, and zygosity was known, eleven of thirteen monozygotic twin pairs (84.6%; 95% CI: 53.7-97.3%) were concordant for CMV infection, and nine of twenty-four dizygotic twin pairs (37.5%; 95% CI: 19.6-59.2%) were concordant for infection giving an estimated hereditability of 94.2%. Within these 37 twin pairs, factors such as primary or recurrent maternal infection, prematurity, growth discordance, and sex are described; however, in many of these cases these factors are unknown.ConclusionThe rate of vertical transmission of congenital CMV is higher for twins than singletons. Discordance of congenital CMV in twins is not rare and suggests a possible genetic susceptibility to congenital CMV.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

Hutton

Rowan

2021

Front. Cell. Infect. Microbiol.

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“…On the other hand, gastrointestinal obstruction and infarction may lead to decreased colloid osmotic pressure due to protein loss, making the prognosis less favourable. Pregnancy evaluation also includes screening for viral, bacterial and parasitic infectious diseases, including parvovirus, cytomegalovirus, syphilis and toxoplasmosis [ 23 , 24 ]. Parvovirus is the most common infectious cause of NIHF.…”

Section: Discussionmentioning

confidence: 99%

Nonimmune Hydrops Fetalis—Prenatal Diagnosis, Genetic Investigation, Outcomes and Literature Review

Kosiński

Krajewski

Wielgoś

et al. 2020

JCM

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The aim of this paper is to review the outcomes and discuss the genetic and non-genetic aetiology of nonimmune hydrops fetalis in order to support differential ultrasound and genetic evaluations and family counselling. This single-centre study includes all cases of nonimmune hydrops fetalis diagnosed prenatally from 2009 to 2019. Two sources of data were used for this study (prenatal and neonatal) to compare and summarise the findings. Data from genetic testing and ultrasound scans were collected. In total, 33 pregnant women with prenatally diagnosed nonimmune hydrops fetalis were studied. The data included 30 cases of singleton (91%) and three cases (9%) of twin pregnancies. There were 14 survivors (43%), seven cases of postnatal deaths (21%), four cases of intrauterine foetal demises (12%), four cases of termination of pregnancy (12%), and four women without a follow up (12%). The total number of chromosomally normal singleton pregnancies was 29 (88%), and 14 foetuses had an anatomical abnormality detected on the ultrasound scan. The chance of survival was the highest in cases of isolated, idiopathic hydrops fetalis, which in most cases was due to an undetectable intrauterine infection. In many cases, the diagnosis could not be established throughout pregnancy. Each case of nonimmune hydrops fetalis should thus be analysed individually.

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“…The sensitivity of CMV IgM for the detection of primary infection has been reported to be 75%; therefore, a repeat serological test might have been helpful for the detection of maternal infection . In a recent study it was reported that maternal CMV IgM were absent in half of cases of congenital CMV infection with ultrasonographic abnormalities and it was thought to be due to the disappearance of antibodies after the primary infection . It was also speculated that the absence of maternal CMV IgM was due to reinfection of the virus, because there were some cases of CMV reinfection in which maternal CMV IgM was not detected .…”

Section: Discussionmentioning

confidence: 99%

“…26 In a recent study it was reported that maternal CMV IgM were absent in half of cases of congenital CMV infection with ultrasonographic abnormalities and it was thought to be due to the disappearance of antibodies after the primary infection. 27 It was also speculated that the absence of maternal CMV IgM was due to reinfection of the virus, because there were some cases of CMV reinfection in which maternal CMV IgM was not detected. 28 Therefore the interpretation of antibody test should be judged carefully, and the detection of CMV DNA by the amniocentesis might be taken into consideration when the congenital CMV infection is suspected clinically or ultrasonographically.…”

Section: Discussionmentioning

confidence: 99%

Significance of maternal screening for toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus infection in cases of fetal growth restriction

Yamamoto

Ishii

Shimada

et al. 2012

J of Obstet and Gynaecol

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Maternal IgM antibody status in confirmed fetal cytomegalovirus infection detected by sonographic signs

Abstract: In around half of fetuses with confirmed CMV infection ascertained by sonographic markers, maternal IgM antibodies are negative and should therefore not be used as a diagnostic parameter.

Cited by 16 publications

References 28 publications

Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

Nonimmune Hydrops Fetalis—Prenatal Diagnosis, Genetic Investigation, Outcomes and Literature Review

Significance of maternal screening for toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus infection in cases of fetal growth restriction

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