Key result
In pregnant women with a primary CMV infection, the presence of a specific CD4 or CD8 T-cell response at the time of diagnosis was not associated with the risk of intrauterine transmission.
Why the study?
Prognostic markers for fetal transmission of CMV during pregnancy are poorly understood, and whether maternal CMV-specific T-cell responses prevent transmission in primary CMV infection was unclear.
Cohort (n=60)
Yes
Odds Ratio: 0.667 (95% CI 0.212–2.104)
p-value: p=0.682
In pregnant women with primary CMV infection, maternal T-cell response at diagnosis does not predict fetal transmission, whereas detectable maternal blood CMV viral load is a relevant biomarker for transmission risk.
Maternal T-cell response at primary CMV diagnosis should not guide transmission risk assessment; leaves open viral load's predictive utility in observational cohorts.
INTRODUCTION: Prognostic markers for fetal transmission of Cytomegalovirus (CMV) infection during pregnancy are poorly understood. Maternal CMV-specific T-cell responses may help prevent fetal transmission and thus, we set out to assess whether this may be the case in pregnant women who develop a primary CMV infection. METHODS: A multicenter prospective study was carried out at 8 hospitals in Spain, from January 2017 to April 2020. Blood samples were collected from pregnant women at the time the primary CMV infection was diagnosed to assess the T-cell response. Quantitative analysis of interferon producing specific CMV-CD8+/CD4+ cells was performed by intracellular cytokine flow cytometry. RESULTS: In this study, 135 pregnant women with a suspected CMV infection were evaluated, 60 of whom had a primary CMV infection and samples available. Of these, 24 mothers transmitted the infection to the fetus and 36 did not. No association was found between the presence of specific CD4 or CD8 responses against CMV at the time maternal infection was diagnosed and the risk of fetal transmission. There was no transmission among women with an undetectable CMV viral load in blood at diagnosis. CONCLUSIONS: In this cohort of pregnant women with a primary CMV infection, no association was found between the presence of a CMV T-cell response at the time of maternal infection and the risk of intrauterine transmission. A detectable CMV viral load in the maternal blood at diagnosis of the primary maternal infection may represent a relevant biomarker associated with fetal transmission.
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Soriano‐Ramos et al. (2023) conducted a cohort in Primary Cytomegalovirus (CMV) infection during pregnancy (n=60). CMV-specific T-cell response (CD8+ IFN-γ production >0.1%) vs. Absence of specific T-cell response (≤0.1%) was evaluated on Intrauterine transmission of CMV to the fetus (OR 0.667, 95% CI 0.212-2.104, p=0.682). In pregnant women with a primary CMV infection, the presence of a specific CD4 or CD8 T-cell response at the time of diagnosis was not associated with the risk of intrauterine transmission.
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