Routine Screening for Rubella and CMV Antibodies During Pregnancy: Is it Justifiable?

Abstract

Rubella and cytomegalovirus (CMV) screening during pregnancy is routinely carried out in India. However, its value has been questioned due to the absence of clearly effective intervention. This retrospective study evaluates the usefulness of rubella and CMV antibody screening during pregnancy. Serum samples received from pregnant women and children were tested for rubella- and CMV-specific IgM antibodies by capture ELISA. The data were analyzed to determine the incidence of rubella and CMV infection during pregnancy and in congenital infections. In asymptomatic pregnant females (n=505), rubella positivity was 3.16% and in women with bad obstetric history (BOH) (n=220), it was 7.72%, while CMV positivity was 5.9% in both asymptomatic pregnant women and in women with BOH. In children (n=200), the overall positivity for rubella- and CMV-specific IgM antibodies was 15 and 25%, respectively. A declining trend was observed in the incidence of both rubella and CMV infections in pregnant women and in women with BOH. In children, the incidence of congenital rubella syndrome has declined, but the incidence of CMV infection has remained almost the same in 5years. The incidence of rubella has reduced over the past 5years and can further be prevented by providing direct protection to women and school girls with rubella vaccines. Primary CMV infection in pregnancy is the main problem, and due to the unavailability of efficient and safe treatment, routine antenatal screening for rubella and CMV should be reserved for women with obstetric complications only.