Risk Factors for Congenital Cytomegalovirus Infection in the Offspring of Young Women: Exposure to Young Children and Recent Onset of Sexual Activity

Fowler, Karen B.; Pass, Robert F.

doi:10.1542/peds.2005-1142

Cited by 148 publications

(123 citation statements)

References 39 publications

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“…Maternal age <25 years and recent onset of sexual activity are known risk factors for CMV. 24 In addition, hydrocephaly, microcephaly and gastroschisis have been associated with maternal infections, 25,26 and it is possible that higher risks for these malformations among teenage mothers are mediated in part by undiagnosed infection.…”

Section: Discussionmentioning

confidence: 99%

Maternal Age-Specific Risk of Nonchromosomal Anomalies

Loane

Dolk

Morris

2009

Obstetrical &Amp; Gynecological Survey

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Objectives To determine the excess risk of non-chromosomal congenital anomaly (NCA) among teenage mothers and older mothers.Design and setting Population-based prevalence study using data from EUROCAT congenital anomaly registers in 23 regions of Europe in 15 countries, covering a total of 1.75 million births from 2000 to 2004.Participants A total of 38 958 cases of NCA that were live births, fetal deaths with gestational age ‡20 weeks or terminations of pregnancy following prenatal diagnosis of a congenital anomaly.Main outcome measures Prevalence of NCA according to maternal age, and relative risk (RR) of NCA and 84 standard NCA subgroups compared with mothers aged 25-29. ResultsThe crude prevalence of all NCA was 26.5 per 1000 births in teenage mothers (<20 years), 23.8 for mothers 20-24 years, 22.5 for mothers 25-29 years, 21.5 for mothers 30-34 years, 21.4 for mothers 35-39 years and 22.6 for mothers 40-44 years. The RR adjusted for country for teenage mothers was 1.11 (95% CI 1.06-1.17); 0.99 (95% CI 0.96-1.02) for mothers 35-39; and 1.01 (95% CI 0.95-1.07) for mothers 40-44. The pattern of maternal age-related risk varied significantly between countries: France, Ireland and Portugal had higher RR for teenage mothers, Germany and Poland had higher RR for older mothers. The maternal age-specific RR varied for different NCAs. Teenage mothers were at a significantly greater risk (P < 0.01) of gastroschisis, maternal infection syndromes, tricuspid atresia, anencephalus, nervous system and digestive system anomalies while older mothers were at a significantly greater risk (P < 0.01) of fetal alcohol syndrome, encephalocele, oesophageal atresia and thanatophoric dwarfism.Conclusions Clinical and public health interventions are needed to reduce environmental risk factors for NCA, giving special attention to young mothers among whom some risk factors are more prevalent. Reassurance can be given to older mothers that their age in itself does not confer extra risk for NCA.

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Section: Discussionmentioning

confidence: 99%

Maternal Age-Specific Risk of Nonchromosomal Anomalies

Loane

Dolk

Morris

2009

Obstetrical &Amp; Gynecological Survey

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“…Human beings are the reservoir hosts for this virus, and the viruses are transmitted by direct contact with saliva, urine, and genital secretions. In pregnant women, the transmission is by direct contact with infected urine or saliva from young children or through sexual activity [8]. The incubation period of CMV infection ranges between 4 and 12 weeks.…”

mentioning

confidence: 99%

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

Prasoona

Buragadda

Sunitha

et al. 2014

J Obstet Gynecol India

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Background The increased complications to the mother and fetus during or after pregnancy and birth are often caused by a wide array of pathogenic organisms mostly belonging to the TORCH group [toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)]. These agents cause asymptomatic or mild infection in the mother while serious consequences in fetus. The present study was aimed to find significant etiological pathogens in the causation of high risk pregnancy (HRP) in South Indian population. Material and Methods A total of 1, 158 HRP women (2010158 HRP women ( -2013 from Modern Government Maternity Hospital, Hyderabad were considered. Two milliliter of blood was obtained and the serum was analyzed for IgG and IgM antibodies against TORCH agents by ELISA. Results Twenty-five percent of the study group had fetal congenital malformation in the present pregnancy (Group 1; N = 291) while 75 % showed bad obstetric history (BOH) (Group 2; N = 867). Maternal age of B25 years, primi gravida, and consanguinity showed predisposing role for Group 1 while maternal age C30 years and C 3 gravida were contributing risk for Group 2. The seropositvity in 123HRP women for toxoplasma, rubella, CMV, and HSV was 28, 84, 92, and 61 %, respectively for IgG while it was 6, 3, 4, and 3 % for IgG ? IgM. Total seropositvity of toxoplasma, rubella, CMV, and HSV in Group 1 was 29, 97, 97, and 62 % while it was 36, 84, 97, and 65 % in Group 2, respectively. Conclusion Maternal age of B25 years, primi gravida, and consanguinity contributed to fetal congenital malformation in the present pregnancy while maternal age of C30 years and C 3 gravida towards BOH. Toxoplasma is protective while rubella and CMV are the infectious agents for HRP. Among the groups, toxoplasma and rubella conferred a predisposing risk towards Group 2 and Group 1, respectively. Sixty-one percent seropositvity of HSV in relation to bad obstetric outcome is the highest prevalence reported so far in India.

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“…Selection of CMV-nontransmitting control mothers was performed using maternal demographic data to match each CMVtransmitting woman (n = 19) to 3 CMV-nontransmitting women (n = 57) on the basis of race/ethnicity, age, and parity, all of which are recognized independent risk factors of cCMV transmission [30,31]. Case and control mothers proved to be well matched on these characteristics, as determined by a 2-sided Fisher's exact test (Supplementary Table 1).…”

Section: Characteristics Of the Study Population And Selection Of Casmentioning

confidence: 99%

Maternal Antibody Responses and Nonprimary Congenital Cytomegalovirus Infection of HIV-1–Exposed Infants

et al. 2016

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Risk of congenital cytomegalovirus (cCMV) transmission is highly dependent on the presence of preexisting maternal immunity, with the lowest rates observed in CMV-seroimmune populations. Among infants of CMV-seroimmune women, those who are exposed to human immunodeficiency virus (HIV) have an increased risk of acquiring cCMV infection as compared to HIV-unexposed infants. To better understand the risk factors of nonprimary cCMV transmission in HIV-infected women, we performed a casecontrol study in which CMV-specific plasma antibody responses from 19 CMV-transmitting and 57 CMV-nontransmitting women with chronic CMV/HIV coinfection were evaluated for the ability to predict the risk of cCMV infection. Primary multivariable conditional logistic regression analysis revealed an association between epithelial-tropic CMV neutralizing titers and a reduced risk of cCMV transmission (odds ratio [OR], 0.18; 95% confidence interval [CI], .03-.93; P = .04), although this effect was not significant following correction for multiple comparisons (false-discovery rate, 0.12). Exploratory analysis of the CMV specificity of plasma antibodies revealed that immunoglobulin G (IgG) responses against the glycoprotein B (gB) neutralizing epitope AD-2 had a borderline association with low risk of transmission (OR, 0.72; 95% CI, .51-1.00; P = .05), although this was not confirmed in a post hoc plasma anti-AD-2 IgG blocking assay. Our data suggest that maternal neutralizing antibody responses may play a role in protection against cCMV in HIV/CMV-coinfected populations.

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Risk Factors for Congenital Cytomegalovirus Infection in the Offspring of Young Women: Exposure to Young Children and Recent Onset of Sexual Activity

Abstract: Caring for young children and recent onset of sexual activity contribute to an increased risk for congenital cytomegalovirus infection in the offspring of young women.

Cited by 148 publications

References 39 publications

Maternal Age-Specific Risk of Nonchromosomal Anomalies

Maternal Age-Specific Risk of Nonchromosomal Anomalies

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

Maternal Antibody Responses and Nonprimary Congenital Cytomegalovirus Infection of HIV-1–Exposed Infants

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