Cytomegalovirus and Pregnancy: A Narrative Review

Area of Science:

• Maternal-fetal medicine
• Neonatology
• Infectious diseases

Background:

• Congenital Cytomegalovirus (CMV) infection is the most common congenital viral infection globally.
• It affects 0.7%-1% of live births, with 11% of infected newborns symptomatic at birth.
• A significant percentage of symptomatic neonates face long-term neurological sequelae.

Purpose of the Study:

• To review the epidemiology and treatment of congenital CMV infection.
• To evaluate recent advancements in preventing vertical transmission and treating symptomatic neonates.
• To inform decisions regarding universal screening protocols for pregnant women.

Main Methods:

• Literature review of recent studies on congenital CMV infection.
• Analysis of treatment efficacy for valacyclovir and ganciclovir.
• Epidemiological data synthesis.

Main Results:

• Valacyclovir (8 g/day) demonstrates efficacy in preventing vertical CMV transmission.
• Ganciclovir is effective in managing long-term sequelae in symptomatic neonates.
• Emerging treatments justify re-evaluation of universal screening for pregnant women.

Conclusions:

• Effective treatments for congenital CMV infection are now available.
• Universal screening protocols for pregnant women should be considered based on local resources and capabilities.
• Early intervention can mitigate severe outcomes of congenital CMV.