Abstract
PurposeTo determine the frequency of fetal infection as well as adverse pregnancy outcomes following antenatal hyperimmunoglobulin (HIG) treatment for primary cytomegalovirus (CMV) infection in pregnancy.MethodsIn our observational cohort study, data from 46 women with a primary CMV infection during pregnancy were evaluated. Primary CMV infection was defined by seroconversion or the presence of CMV-IgM and low CMV-IgG avidity. All women received at least two or more infusions of HIG treatment (200 IU/kg). Congenital CMV infection (cCMV) was diagnosed by detection of CMV in amniotic fluid and/or neonatal urine. We compared the rate of maternal–fetal transmission from our cohort to data without treatment in the literature. The frequency of adverse pregnancy outcomes was compared to those of live-born infants delivered in our clinic.ResultsWe detected 11 intrauterine infections in our cohort, which correlates to a transmission rate of 23.9%. Compared to the transmission rate found in cases without treatment (39.9%), this is a significant reduction (P = 0.026). There were no adverse pregnancy outcomes in our cohort. The mean gestational age at delivery was 39 weeks gestation in treatment and control group.ConclusionThe administration of HIG for prevention of maternal–fetal CMV transmission during pregnancy seems safe and effective.
Highlights
Congenital cytomegalovirus infection is the main cause of hearing loss and mental retardation in infants without genetic disorder [1]
In a non-randomized and non-controlled study, high-dose Valacyclovir was used for women with primary CMV infection during pregnancy which resulted in a better outcome for newborns with Congenital cytomegalovirus infection (cCMV) [17]
The option of HIG treatment was discussed with women with primary CMV infection during pregnancy
Summary
Congenital cytomegalovirus infection (cCMV) is the main cause of hearing loss and mental retardation in infants without genetic disorder [1]. The rate of cCMV differs depending on whether the infection of the fetus results from a recurrence of an earlier CMV infection of the mother or if the. In a recent study of 138 children with cCMV, amniocentesis (AC) was performed in all pregnancies, predominantly at about 20–23 weeks gestation. In the cohort of infants with a negative CMV-DNA AC, with intrauterine infection later during the pregnancy, none of the children had long-term complications after birth. In the cohort with a positive AC at about 20–23 weeks gestation, 14% suffered from long-term sequelae [15]. In a non-randomized and non-controlled study, high-dose Valacyclovir was used for women with primary CMV infection during pregnancy which resulted in a better outcome for newborns with cCMV [17]. For in utero treatment with Valganciclovir, there are only case reports available [18]
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