Abstract
BackgroundCytomegalovirus (CMV) is the most prevalent congenital viral infection and thus places an enormous disease burden on newborn infants. Seroprevalence of maternal antibodies to CMV due to CMV exposure prior to pregnancy is currently the most important protective factor against congenital CMV disease. The aim of this study was to identify potential predictors, and to develop and evaluate a risk-predicting model for the maternal CMV serostatus in early pregnancy.MethodsMaternal and paternal background information, as well as maternal CMV serostatus in early pregnancy from 882 pregnant women were analyzed. Women were divided into two groups based on their CMV serostatus, and were compared using univariate analysis. To predict serostatus based on epidemiological baseline characteristics, a multiple logistic regression model was calculated using stepwise model selection. Sensitivity and specificity were analyzed using ROC curves. A nomogram based on the model was developed.Results646 women were CMV seropositive (73.2%), and 236 were seronegative (26.8%). The groups differed significantly with respect to maternal age (p = 0.006), gravidity (p<0.001), parity (p<0.001), use of assisted reproduction techniques (p = 0.018), maternal and paternal migration background (p<0.001), and maternal and paternal education level (p<0.001). ROC evaluation of the selected prediction model revealed an area under the curve of 0.83 (95%CI: 0.8–0.86), yielding sensitivity and specificity values of 0.69 and 0.86, respectively.ConclusionWe identified predictors of maternal CMV serostatus in early pregnancy and developed a risk-predicting model based on baseline epidemiological characteristics. Our findings provide easy accessible information that can influence the counseling of pregnant woman in terms of their CMV-associated risk.
Highlights
Cytomegalovirus (CMV) is a member of the betaherpesvirinae subfamily of herpes viruses
We identified predictors of maternal CMV serostatus in early pregnancy and developed a risk-predicting model based on baseline epidemiological characteristics
Our findings provide easy accessible information that can influence the counseling of pregnant woman in terms of their CMV-associated risk
Summary
Cytomegalovirus (CMV) is a member of the betaherpesvirinae subfamily of herpes viruses. Among women of reproductive age, the prevalence of antibodies in the serum (i.e., seropositivity) due to prior CMV exposure ranges from 45% in developed countries to 100% in developing countries and is associated with several epidemiological factors, including age, gravidity, parity, place of birth, and socioeconomic status.[3,4,5,6] Because seroprevalence rates can reflect the size of the virus reservoir, maternal serostatus can have an impact on the incidence of congenital CMV infection.[7] CMV is the most prevalent congenital viral infection, affecting 0.64% of newborn infants.[8, 9] this prevalence varies widely among study populations; For example, in Europe, a highly industrialized region with relatively low overall maternal CMV seroprevalence, regional CMV seroprevalence ranges from as low as 0.1% to as high as 2%.[8] In developing countries with high rates of maternal CMV seropositivity, even higher rates (1–5.4%) of congenital CMV prevalence have been reported.[10, 11]. The aim of this study was to identify potential predictors, and to develop and evaluate a risk-predicting model for the maternal CMV serostatus in early pregnancy
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