Guidelines on CMV congenital infection

Oriol Coll, Guillaume Benoist, Yves Ville, Leonard E Weisman, Francesc Botet, WAPM Perinatal Infections Working Group, Maurizio M Anceschi, Anne Greenough, Ronald S Gibbs, Xavier Carbonell-Estrany

    Research output: Contribution to journalLiterature reviewpeer-review

    93 Citations (Scopus)

    Abstract

    Congenital cytomegalovirus (CMV) infection occurs in 0.6-0.7% of all newborns and is the most prevalent infection-related cause of congenital neurological handicap. Vertical transmission occurs in around 30% of cases, but the fetus is not always affected. Symptomatic newborns at birth have a much higher risk of suffering severe neurological sequelae. Detection of specific IgG and IgM and IgG avidity seem to be the most reliable tests to identify a primary infection but interpretation in a clinical context may be difficult. If a seroconversion is documented or a fetal infection is suspected by ultrasound markers, an amniocentesis should be performed to confirm a vertical transmission. In the absence of a confirmed fetal infection with fetal structural anomalies, a pregnancy termination should be discouraged. Fetal prognosis is mainly correlated to the presence of brain damage. Despite promising results with the use of antiviral drugs and CMV hyperimmune globulin (HIG), results have to be interpreted with caution. Pregnant women should not be systematically tested for CMV during pregnancy. Managing CMV screening should be restricted to pregnancies where a primary infection is suspected or among women at high risk. The magnitude of congenital CMV disease and the value of interventions to prevent its transmission or to decrease the sequelae need to be established before implementing public health interventions. In this paper, aspects of CMV infection in the pregnant woman and her infant are reviewed.
    Original languageEnglish
    Pages (from-to)433 - 445
    Number of pages13
    JournalJournal of Perinatal Medicine
    Volume37
    Issue number5
    DOIs
    Publication statusPublished - 1 Sept 2009

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