Cytomegalovirus infection in pregnancy - An update

Area of Science:

• Virology
• Public Health
• Maternal-Fetal Medicine

Background:

• Cytomegalovirus (CMV) is a widespread DNA virus with 83% global seroprevalence.
• It is the leading cause of non-genetic sensorineural hearing loss and congenital disabilities like cerebral palsy.
• Maternal CMV infection during pregnancy can lead to congenital CMV (cCMV) with severe fetal effects, especially before 20 weeks gestation.

Purpose of the Study:

• To highlight the public health significance of CMV and congenital CMV (cCMV).
• To discuss transmission routes, risk factors, and fetal outcomes associated with maternal CMV infection.
• To review diagnostic methods for maternal and fetal CMV and outline prevention strategies.

Main Methods:

• Review of existing literature on Cytomegalovirus (CMV) and congenital CMV (cCMV).
• Analysis of transmission dynamics, diagnostic criteria, and clinical manifestations.
• Evaluation of current prevention strategies and unproven interventions.

Main Results:

• CMV transmission occurs via bodily fluids, with higher rates in primary infections and increasing with gestational age.
• Congenital CMV (cCMV) can cause fetal abnormalities, growth restriction, and loss; diagnosis relies on seroconversion, IgM/IgG detection, and low avidity.
• Prenatal diagnosis via amniocentesis is imperfect, requiring specific timing post-infection and gestational age.

Conclusions:

• Congenital CMV (cCMV) is a significant public health concern due to its prevalence and severe consequences.
• Effective prevention relies on hygiene education for pregnant women, as vaccines and antiviral therapies lack proven efficacy.
• Early diagnosis and understanding transmission are crucial for managing and preventing congenital CMV (cCMV) infections.