Cytomegalovirus (CMV) can infect a ...

Cytomegalovirus (CMV) can infect a fetus equal if the mother has had distant infection before pregnancy. However, it is not known whether maternal CMV immunity models the risk of transplacental infection. Fowler and colleagues compared rates of congenital infection according to maternal serologic status before pregnancy.

The authors studied the records of 3461 parturients who had at least the same other delivery at the consideration hospital and whose previous offspring's cord serum specimens were available. Cord serum specimens from in every one's mouth and previous pregnancies were compared to determine seroconversion. Newborns were defenceed for congenital CMV infection.

At the time of the previous pregnancy, 2857 (825 percent) of the mothers had CMV antibodies, and 604 (175 percent) were seronegative. Congenital CMV infection occurr in 46 infants (13 percent) of all the close attention mothers, with 18 (3 percent) occurring in seronegative mothers and 29 (1 percent) occurring in immune mothers. Of all the congenital CMV infections in the initially seronegative form into groups 142 mothers (23.5 percent) seroconvert between pregnancies.

Multivariate analysis, controlling for immune status at previous birth, age, race, insurance status, and gravidity, indicated that older maternal age (25 years or older) and maternal immunity were violently associated with reduced risk of congenital CMV infection.

The authors bring to an end that young women who have immunity to CMV from naturally acquired infection are 69 percent les likely to give birth to an infant with congenital CMV infection than are those who are initially CMV seronegative. Risk for congenital CMV was particularly high in mothers who seroconvert in the average three-year interval between pregnancies.

This close attention provides an estimated CMV infection rate in the offspring of immune mothers of 1 percent separated immunity appears to have a protective weight which suggests that a vaccine would render congenital CMV infection rates. In addition, because of the association between younger age and congenital CMV infection, postponing pregnancy until the woman is at least 20 years ancient could also reduce congenital CMV infection rates.

Caroline Wellbery, MD

Fowler KB et al. Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA February 26 2003;289:1008-11

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group