Early first-trimester CMV screening in a regional perinatal network: a multicenter descriptive study

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Neonatology

Background:

• Congenital cytomegalovirus (CMV) infection is the most common congenital infection globally.
• Systematic first-trimester CMV screening in pregnancy is under debate, with France recommending nationwide screening in June 2025.
• This study evaluated early CMV screening in a regional network before national implementation.

Purpose of the Study:

• To describe maternal-fetal transmission, neonatal infection, and pregnancy outcomes after implementing early CMV screening.
• To assess antenatal management strategies, including valaciclovir use.
• To evaluate pregnancy outcomes in a real-world setting.

Main Methods:

• Retrospective, multicenter observational study in three maternity units.
• Included patients with primary CMV infection diagnosed periconceptionally or in the first trimester (up to 14 weeks gestation).
• Analyzed maternal-fetal transmission rates, neonatal outcomes, and management strategies.

Main Results:

• 38 primary CMV infections identified among 29,657 deliveries.
• Valaciclovir used in 47% of cases; amniocentesis performed in 68%.
• Congenital CMV infection rate was 10.5%; 3 newborns tested positive, and 1 pregnancy was terminated.

Conclusions:

• Early CMV screening facilitated the identification and management of primary maternal infections in routine practice.
• The descriptive nature and small sample size limit conclusions on clinical effectiveness or impact on vertical transmission.
• Further research is needed to establish the efficacy of early screening programs.