Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity.

Masatoki Kaneko,Toshio Minematsu,Kazumi Kusumoto,Junsuke Muraoka

doi:10.3390/v13050866

Abstract

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

Highlights

Human cytomegalovirus (CMV) is the most common virus that causes morbidity and mortality in congenitally infected fetuses and newborns, resulting in a broad range of disabilities, including sensorineural hearing loss, visual impairment, and motor and cognitive deficits [1]
Congenital CMV infection was confirmed in 19 cases, including 13 (15.7%) with low IgG avidity index (AI), 0 with moderate IgG AI, and 6 (2.1%) with high
Our results indicate that low IgG AI during pregnancy was the most profound risk factor of congenital CMV infection in pregnant women with CMV IgM positivity

Summary

Introduction

Human cytomegalovirus (CMV) is the most common virus that causes morbidity and mortality in congenitally infected fetuses and newborns, resulting in a broad range of disabilities, including sensorineural hearing loss, visual impairment, and motor and cognitive deficits [1]. The prevalence rates of congenital CMV infection range from 0.2% to. In. Japan, congenital CMV infection was reported to occur in 0.31% of newborns [3]. No global consensus has been reached regarding maternal serum screening for CMV infection [1,2,4,5]. Universal screening would aid in starting a proper ultrasound follow-up of fetuses whose mothers’ results show CMV infection. An example could be abnormality of the fetal heart rate, which can be caused by neurological damage due to CMV infection [7]

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Results

Conclusion