Socio-biologic Predictors of Active Cytomegalovirus Infection Among Pregnant Women in a Low-resource Setting

Awoleke Jacob Olumuyiwa

doi:10.11648/j.jgo.20190701.14

Abstract

Active maternal cytomegalovirus (CMV) infection is the bedrock of congenital CMV with its debilitating sequelae. Information on socio-biologic predictors of active maternal infection in southwest Nigeria is lacking. However, modifying locality-specific risk factors could reduce the burden of CMV. The aim of the study is to identify the socio-biologic determinants for active maternal CMV infection in a Nigerian setting. Using a cross-sectional design, ELISA kits were employed to quantify the anti-CMV IgG and IgM antibodies in the sera of consecutive antenatal attendees at the Ekiti State University Teaching Hospital (EKSUTH), Nigeria. Among the respondents, 23 (12.4%) were seropositive for both anti-CMV IgG and IgM antibodies. The regression analysis showed that the likelihood of being seropositive for both anti-CMV IgG and IgM antibodies was predicted by having a child less than 5 years old (adjusted OR: 5.53; 95% CI: 1.08 – 28.30; p = 0.04), while those who were skilled workers were least likely to be seropositive for both antibodies (adjusted OR: 0.06; 95% CI: 0.01 – 0.95; p = 0.04). Also, infection with cytomegalovirus was associated with pre-eclampsia (adjusted OR: 0.03; 95% CI: 0.002 – 0.41; p = 0.01). High prevalence of active maternal CMV infection was noted from the study, and this was associated with pre-eclampsia and caring for children under-5. Educating pregnant non-immune women about CMV and its prevention, coupled with the improvement in socio-economic status of the populace can reduce the burden in low-resource settings.

Highlights

Cytomegalovirus (CMV) is the commonest cause of intrauterine viral infection, occurring in 0.2% to 2.2% of all live births
There is increasing evidence that non-primary infections could lead to Awoleke Jacob Olumuyiwa et al.: Socio-biologic Predictors of Active Cytomegalovirus Infection
The likelihood of being seropositive for both anti-CMV immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies was predicted by having a child less than 5 years old, while those who were skilled workers were least likely to be seropositive for both antibodies

Summary

Introduction

Cytomegalovirus (CMV) is the commonest cause of intrauterine viral infection, occurring in 0.2% to 2.2% of all live births. Congenital CMV is the leading infectious cause of mental retardation and sensori-neural deafness globally [1]. Pregnant women can be infected with CMV when they come in contact with the saliva or urine of an infected young child, or during sexual intercourse just before or during pregnancy [4]. Mother-to-child transmission of CMV is mainly the result of primary maternal CMV infection. There is increasing evidence that non-primary infections (usually following re-activation of a latent endogenous virus or re-infection by a viral strain from an exogenous source which differs from the previous strain in epitopes of envelope glycoproteins) could lead to Awoleke Jacob Olumuyiwa et al.: Socio-biologic Predictors of Active Cytomegalovirus Infection

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