DOI QR코드

DOI QR Code

Cytomegalovirus Infection among Pregnant Women in Beijing: Seroepidemiological Survey and Intrauterine Transmissions

  • Jin, Qing'e (Department of Clinical Laboratory, Capital Medical University Affiliated Beijing Friendship Hospital) ;
  • Su, Jianrong (Department of Clinical Laboratory, Capital Medical University Affiliated Beijing Friendship Hospital) ;
  • Wu, Shanna (Department of Clinical Laboratory, Capital Medical University Affiliated Beijing Friendship Hospital)
  • Received : 2016.12.16
  • Accepted : 2017.03.09
  • Published : 2017.05.28

Abstract

Primary cytomegalovirus (CMV) infection during pregnancy can cause congenital defects. Available data for CMV infection during pregnancy in north China are inadequate. The aim of this study was to evaluate the epidemiology of maternal CMV infection and explore the incidence of congenital infection. In this prospective study, serum CMV IgG and IgM antibodies were measured in 2,887 pregnant women using ELISA, and the IgG avidity test was performed on all IgM-positive subjects. The seroprevalence of anti-CMV IgG was 94.70%, and of anti-CMV IgM was 1.28%. CMV IgG prevalence increased significantly with age (p < 0.01). Women living in downtown areas showed higher IgG prevalence than those residing in urban areas (p = 0.023). CMV-IgM seroprevalence was highest in autumn (p = 0.021). There was no difference in IgM seroprevalence by age, socioeconomic status, geographical area, or gravida. The rate of primary CMV infection was 0.45% (13/2,887) at the first trimester. The seroconversion rate during pregnancy was 0.76% (22/2,887). One woman underwent seroconversion during pregnancy and gave birth to an infant with asymptomatic CMV infection. Congenital CMV infection was diagnosed in five of the 14 infants from 14 mothers with active infection, for a vertical transmission rate of 35.71% (5/14). Three infants were asymptomatic, whereas two infants presented symptomatic infection with hearing deficits. Although CMV IgG prevalence is relatively high in north China, significant attention to primary CMV infection during pregnancy is still needed.

Keywords

References

  1. Cannon MJ, Schmid DS, Hyde TB. 2010. Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev. Med. Virol. 20: 202-213. https://doi.org/10.1002/rmv.655
  2. Adams WK, McAdams RM. 2013. Influence of infection during pregnancy on fetal development. Reproduction 146: R151-R162. https://doi.org/10.1530/REP-13-0232
  3. Enders G, Daiminger A, Lindemann L, Knotek F, Bader U, Exler S, Enders M. 2012. Cytomegalovirus (CMV) seroprevalence in pregnant women, bone marrow donors and adolescents in Germany, 1996-2010. Med. Microbiol. Immunol. 201: 303-309. https://doi.org/10.1007/s00430-012-0232-7
  4. Korndewal MJ, Mollema L, Tcherniaeva I, van der Klis F, Kroes AC, Oudesluys-Murphy AM, et al. 2015. Cytomegalovirus infection in the Netherlands: seroprevalence, risk factors, and implications. J. Clin. Virol. 63: 53-58. https://doi.org/10.1016/j.jcv.2014.11.033
  5. Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK. 2013. The "silent" global burden of congenital cytomegalovirus. Clin. Microbiol. Rev. 26: 86-102. https://doi.org/10.1128/CMR.00062-12
  6. Revello MG, Gerna G. 2002. Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant. Clin. Microbiol. Rev. 15: 680-715. https://doi.org/10.1128/CMR.15.4.680-715.2002
  7. Munro SC, Hall B, Whybin LR, Leader L, Robertson P, Maine GT, Rawlinson WD. 2005. Diagnosis of and screening for cytomegalovirus infection in pregnant women. J. Clin. Microbiol. 43: 4713-4718. https://doi.org/10.1128/JCM.43.9.4713-4718.2005
  8. Prince HE, Lape-Nixon M. 2014. Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy. Clin. Vaccine Immunol. 21: 1377- 1384. https://doi.org/10.1128/CVI.00487-14
  9. Lazzarotto T, Guerra B, Lanari M, Gabrielli L, Landini MP. 2008. New advances in the diagnosis of congenital cytomegalovirus infection. J. Clin. Virol. 41: 192-197. https://doi.org/10.1016/j.jcv.2007.10.015
  10. Dollard SC, Staras SA, Amin MM, Schmid DS, Cannon MJ. 2011. National prevalence estimates for cytomegalovirus IgM and IgG avidity and association between high IgM antibody titer and low IgG avidity. Clin. Vaccine Immunol. 18: 1895-1899. https://doi.org/10.1128/CVI.05228-11
  11. Li Z, Yan C, Liu P, Yan R, Feng Z. 2009. Prevalence of serum antibodies to TORCH among women before pregnancy or in the early period of pregnancy in Beijing. Clin. Chim. Acta 403: 212-215. https://doi.org/10.1016/j.cca.2009.03.027
  12. Yamamoto AY, Castellucci RA, Aragon DC, Mussi-Pinhata MM. 2013. Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection. Epidemiol. Infect. 141: 2187-2191. https://doi.org/10.1017/S0950268812002695
  13. Mujtaba G, Shaukat S, Angez M, Alam MM, Hasan F, Zahoor Zaidi SS, Shah AA. 2016. Seroprevalence of human cytomegalovirus (HCMV) infection in pregnant women and outcomes of pregnancies with active infection. J. Pak. Med. Assoc. 66: 1009-1014.
  14. Bate SL, Dollard SC, Cannon MJ. 2010. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin. Infect. Dis. 50: 1439-1447. https://doi.org/10.1086/652438
  15. Taniguchi K, Watanabe N, Sato A, Jwa SC, Suzuki T, Yamanobe Y, et al. 2014. Changes in cytomegalovirus seroprevalence in pregnant Japanese women - a 10-year single center study. J. Clin. Virol. 59: 192-194. https://doi.org/10.1016/j.jcv.2013.12.013
  16. Kouri V, Correa CB, Verdasquera D, Martinez PA, Alvarez A, Aleman Y, et al. 2010. Diagnosis and screening for cytomegalovirus infection in pregnant women in Cuba as prognostic markers of congenital infection in newborns: 2007-2008. Pediatr. Infect. Dis. J. 29: 1105-1110. https://doi.org/10.1097/INF.0b013e3181eb7388
  17. Wang C, Dollard SC, Amin MM, Bialek SR. 2016. Cytomegalovirus IgM seroprevalence among women of reproductive age in the United States. PLoS One 11: e0151996. https://doi.org/10.1371/journal.pone.0151996
  18. Zhang S, Hu L, Chen J, Xu B, Zhou YH, Hu Y. 2014. Cytomegalovirus seroprevalence in pregnant women and association with adverse pregnancy/neonatal outcomes in Jiangsu Province, China. PLoS One 9: e107645. https://doi.org/10.1371/journal.pone.0107645
  19. Shigemi D, Yamaguchi S, Otsuka T, Kamoi S, Takeshita T. 2015. Seroprevalence of cytomegalovirus IgG antibodies among pregnant women in Japan from 2009-2014. Am. J. Infect. Control 43: 1218-1221. https://doi.org/10.1016/j.ajic.2015.06.026
  20. Dollard SC, Grosse SD, Ross DS. 2007. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev. Med. Virol. 17: 355-363. https://doi.org/10.1002/rmv.544
  21. Boppana SB, Rivera LB, Fowler KB, Mach M, Britt WJ. 2001. Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N. Engl. J. Med. 344: 1366-1371. https://doi.org/10.1056/NEJM200105033441804
  22. Forner G, Abate D, Mengoli C, Palu G, Gussetti N. 2015. High cytomegalovirus (CMV) DNAemia predicts CMV sequelae in asymptomatic congenitally infected newborns born to women with primary infection during pregnancy. J. Infect. Dis. 212: 67-71. https://doi.org/10.1093/infdis/jiu627

Cited by

  1. Clinical Features of CMV-Associated Anterior Uveitis vol.26, pp.1, 2018, https://doi.org/10.1080/09273948.2017.1394471
  2. Seroepidemiology of Cytomegalovirus Infection in Pregnant Women in the Central Mexican City of Aguascalientes vol.10, pp.4, 2018, https://doi.org/10.14740/jocmr3358w
  3. Changes in Cytomegalovirus Seroprevalence in Korea for 21 Years: a Single Center Study vol.25, pp.3, 2017, https://doi.org/10.14776/piv.2018.25.e8
  4. High prevalence of breastmilk‐acquired cytomegalovirus infection in jaundiced infants vol.34, pp.2, 2017, https://doi.org/10.1002/jcla.23199
  5. Genetic variation in toll like receptors 2, 7, 9 and interleukin-6 is associated with cytomegalovirus infection in late pregnancy vol.21, pp.None, 2020, https://doi.org/10.1186/s12881-020-01044-8
  6. Congenital Cytomegalovirus Infections Mother-Newborn Pair Study in Southern Ethiopia vol.2021, pp.None, 2017, https://doi.org/10.1155/2021/4646743
  7. Predictive significance of neutrophil‐to‐lymphocyte and platelet‐to‐lymphocyte for cytomegalovirus infection in infants less than 3 months: A retrospective study vol.36, pp.1, 2017, https://doi.org/10.1002/jcla.24131