Prevention of Acquisition of Cytomegalovirus Infection in Pregnancy Through Hygiene-based Behavioral Interventions: A Systematic Review and Gap Analysis.

Abstract

Congenital cytomegalovirus infection is the most common nongenetic cause of sensorineural hearing loss in childhood and an important cause of neurodisability. There is no licensed cytomegalovirus (CMV) vaccine and no antenatal treatment for congenital CMV that is routinely recommended in clinical practice in the United Kingdom. To review the published literature for studies that evaluated preventative hygiene-based interventions in pregnancy for their impact on knowledge about CMV prevention, the uptake of preventative behaviors or the acquisition of CMV in pregnancy. Searches were carried out in Medical Literature Analysis and Retrieval System Online and Cumulative Index of Nursing and Allied Health Literature databases. All human studies, limited to women of childbearing age were included. Two reviewers independently assessed the quality of the methods and results of included articles. Extracted data were classified using Cochrane guidelines. Seven studies met the inclusion criteria. These show that preventative measures are acceptable to pregnant women, can impact their behavior and have the potential to reduce CMV in pregnancy. They are limited by several factors; sample size, nonrandomized trial design and interventions that are beyond routine clinical practice. An effective intervention that changes behavior in pregnancy and reduces the risk of CMV acquisition is needed as part of routine care. There is currently insufficient evidence about the form that this intervention should take. PROSPERO registration number: CRD42017069666.