Preconception screening for cytomegalovirus: an effective preventive approach

Area of Science:

• Virology
• Infectious Diseases
• Public Health

Background:

• Congenital cytomegalovirus (CMV) is a primary cause of sensorineural hearing loss and developmental delays.
• Primary maternal CMV infection poses a higher risk of fetal transmission than secondary infections.
• Limited treatment options during pregnancy underscore the importance of primary prevention strategies.

Purpose of the Study:

• To evaluate the effectiveness of preconception cytomegalovirus (CMV) testing and counseling in reducing CMV exposure among women attending a fertility clinic.
• To assess the incidence of CMV infection in women advised on preventive measures before conception.

Main Methods:

• A cohort of 500 women planning pregnancy underwent CMV screening.
• Serological testing (IgM, IgG avidity) identified recent, remote, or no prior CMV infection.
• Women with recent infection were advised to delay pregnancy; susceptible women received counseling on hygiene and exposure minimization.

Main Results:

• Of 444 screened women, 4.1% had recent CMV infection (IgM positive, low IgG avidity) and were advised to delay pregnancy.
• 82.4% of women were seroimmune to CMV.
• Of 72 susceptible women followed for one year, only 4.2% acquired CMV infection, demonstrating high efficacy of preventive advice.

Conclusions:

• Preconception cytomegalovirus (CMV) screening and counseling are effective in reducing CMV exposure in women undergoing fertility treatments.
• This strategy aids in preventing primary CMV infections during pregnancy, thereby mitigating risks of congenital CMV transmission.
• Implementing CMV screening and counseling in fertility settings is a viable primary prevention approach.