Risk Factors For Congenital Infection Research Articles

Anti-cytomegalovirus immunoglobulin M titer for congenital infection in first-trimester pregnancy with primary infection: a multicenter prospective cohort study.

We evaluated cytomegalovirus (CMV) immunoglobulin M (IgM) titer in pregnant women with primary infection as a predictive factor for congenital infection. Maternal CMV antibody screening during the first trimester was conducted prospectively at 16 centers in Japan between September 2013 and 2015. Women with confirmed maternal primary infection underwent testing for fetal congenital infection, and we investigated the positive predictive value of CMV IgM titer levels for congenital infection in women with a low IgG avidity. We identified 6 (8.6%) cases of congenital infection among 70 pregnant women with positive/borderline IgG, positive IgM and IgG avidity index ⩽35.0% and 11 (39.3%) among 28 women with IgG and/or IgM seroconversion. IgM titer level ⩾6.00 index showed the highest positive predictive value (17.1%). High titer of CMV IgM during the first trimester in pregnant women with primary infection is a risk factor for congenital infection.

A Neonate with Reduced Cytomegalovirus DNA Copy Number and Marked Improvement of Hearing in the Treatment of Congenital Cytomegalovirus Infection

Congenital cytomegalovirus (CMV) infection can cause severe permanent disabilities. A mother who is seronegative before conception but acquires infection during pregnancy is a risk factor for congenital infection. We describe a neonate in whom congenital CMV infection was diagnosed at birth and confirmed with DNA quantitation by means of the polymerase chain reaction, was accompanied by cerebral ventriculomegaly and severe hearing loss, and was treated with ganciclovir/valganciclovir for 6 weeks. Initially, cerebral ventriculomegaly and calcification were also found with computed tomography, and severe hearing loss was detected with auditory brainstem response testing. After treatment, CMV DNA decreased in copy number and became undetectable. No marked side effects occurred after treatment. Surprisingly, 1 year after treatment, neurological and motor development was equivalent to that in a healthy infant. Audiometry indicated that auditory ability would improve with rehabilitation, speech and language therapy, and cochlear implantation. Single-photon emission computed tomography showed marked improvement 6 months after treatment. This case provides compelling evidence that a reliable diagnosis of congenital CMV infections coupled with a prompt and appropriate treatment program can prevent permanent disability. It is, therefore, important to establish a more effective strategy for the management of congenital CMV infection.

Risk factors and consequences of congenital Chagas disease in Yacuiba, south Bolivia

To determine the risk factors of congenital Chagas disease and the consequences of the disease in newborns. Study of 2712 pregnant women and 2742 newborns in Yacuiba, south Bolivia. Chagas infection was determined serologically in mothers and parasitologically in newborns. Consequences of congenital Chagas disease were assessed clinically. The prevalence of Chagas disease in pregnant women was 42.2%. Congenital transmission was estimated at 6% of infected mothers leading to an incidence rate of 2.6% among newborns. Main risk factors of congenital transmission were mothers' seropositivity and maternal Trypanosoma cruzi parasitaemia. Parity was higher in infected than in non-infected mothers, but it was not associated with the risk of congenital transmission. The rate of congenital infection was significantly higher in newborns from multiple pregnancies than in singletons. However, we did not observe statistically significant consequences of Chagas disease in newborns from single pregnancies or among twins. The main risk factors for congenital transmission were infection and parasitaemia of mothers. Consequences of the disease seemed mild in newborns from single pregnancies and perhaps more important in multiple births.

Serum C‐reactive protein is a useful marker for congenital infection

Serial quantitative measurements of C‐reactive protein (CRP) were performed by reaction rate nephelometry on cord blood and scrum of 70 babies (60 preterm and 10 full term). There were 41 babies born to mothers with no risk factors for bacterial infection (Group 1) and 29 babies born to mothers with risk factors (Group 2), Maternal risk factors for congenital infection were: a history of prolonged rupture of membranes, maternal treatment with antibiotics, chorioamnionitis or positive cultures from high vaginal swabs. Twelve babies had raised CRP levels (>10 mg/1), 2 from Group 1 and 10 from Group 2, 9 of whom were subsequently found to have bacterial infections. One of the 2 babies without suspected infection had severe birth asphyxia. Specificity, sensitivity, positive and negative predictive values were calculated for CRP levels and total white cell counts (TWCC). Within Group 2, the specificity of raised CRP for diagnosis of congenital bacterial infection was 95% and the sensitivity was 100%, compared to the specificity of TWCC 95% and sensitivity 55%. CRP can be used as a marker for congenital bacterial infection and appears to be more sensitive than TWCC.