Congenital cytomegalovirus infection: A narrative review

Abstract

Cytomegalovirus (CMV) infection poses significant health risks, particularly for vulnerable populations including fetuses infected in utero, premature infants, and immunocompromised individuals. CMV infection is the most prevalent cause of congenital infection, affecting approximately 0.5% to 2% of all live births worldwide. Congenital transmission during pregnancy is a major concern, with a variety of fetal and neonatal outcomes ranging from asymptomatic infection to severe abnormalities, including sensorineural hearing loss, visual impairment, various neurological sequelae, growth retardation and potentially fatal consequences. Congenital transmission of CMV from mother to fetus can occur through primary infection, or reactivation of a previous infection. Diagnosis involves imaging techniques and invasive procedures to detect CMV DNA. Antiviral medications have limited data for use during pregnancy, while ganciclovir or valganciclovir demonstrates potential benefits in neonates with symptomatic disease. Routine antenatal screening is not yet recommended, but serological testing may be warranted in specific circumstances. Preventive measures focus on simple hygiene practices. Childbirth and breastfeeding present potential risks of CMV transmission, highlighting the importance of close monitoring and informed decision-making. This narrative review aims to provide a comprehensive summary of the epidemiology, transmission patterns, clinical manifestations, diagnostic approaches, treatment modalities, screening methods, preventive measures, and breastfeeding considerations related to CMV infection. This knowledge is essential for healthcare professionals to effectively manage CMV infection and improve outcomes for affected individuals and their families.