Key result
Maternal CMV DNAemia indicated a higher risk of congenital CMV infection with odds ratios of 5.7, 6.5, and 13.0 in early, middle, and late pregnancy, while maternal serological testing was not.
Why the study?
The value of widely applied maternal CMV serological testing for predicting intrauterine transmission in highly seroprevalent regions remains unknown.
Does maternal serological testing or DNAemia predict congenital CMV infection in highly seroprevalent regions?
Case-Control (n=192)
Does maternal serological testing or DNAemia predict congenital CMV infection in highly seroprevalent regions?
Effect estimate: OR 5.7, 6.5, and 13.0
In highly seroprevalent regions, maternal CMV serological testing has limited value for predicting congenital infection, whereas detection of DNAemia is helpful in assessing transmission risk.
Maternal CMV IgM and avidity testing may not predict transmission in high-seroprevalence regions; leaves open need for alternative risk markers.
BACKGROUND: The value of the widely applied maternal cytomegalovirus (CMV) serological testing approach in predicting intrauterine transmission in highly seroprevalent regions remains unknown. METHODS: A nested case-control study was conducted based on a maternal-child cohort study. Newborns with congenital CMV (cCMV) infection were included, and each of them was matched to 3 newborns without cCMV infection. Retrospective samples were tested for immunoglobulin G (IgG) avidity and immunoglobulin M (IgM) antibodies in maternal serum and CMV DNA in maternal blood and urine to analyze their associations with cCMV infection. RESULTS: Forty-eight newborns with cCMV infection and 144 matched newborns without infection were included in the study. Maternal IgM antibodies and IgG avidity during pregnancy were not statistically associated with intrauterine transmission. The presence of CMV DNAemia indicated a higher risk of cCMV infection, with odds ratio values of 5.7, 6.5, and 13.0 in early, middle, and late pregnancy, respectively. However, the difference in CMV shedding rates in transmitters and nontransmitters was not significant in urine. CONCLUSIONS: The value of current maternal CMV serological testing in regions with high seropositivity rates is very limited and should be reconsidered. The detection of DNAemia would be helpful in assessing the risk of intrauterine transmission.
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Huang et al. (2023) conducted a case-control in Congenital CMV (cCMV) infection (n=192). Maternal CMV DNAemia and serological testing vs. Absence of maternal CMV DNAemia was evaluated on Congenital CMV (cCMV) infection (OR 5.7, 6.5, and 13.0). Maternal CMV DNAemia indicated a higher risk of congenital CMV infection with odds ratios of 5.7, 6.5, and 13.0 in early, middle, and late pregnancy, while maternal serological testing was not.
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