A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome

Authors

  • O. Picone,

    Corresponding author
    • Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
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  • C. Vauloup-Fellous,

    1. INSERM U764, Université Paris-Sud, AP-HP, Microbiology Department, Hôpital Antoine Béclère, Clamart, France
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  • A. G. Cordier,

    1. Department of Obstetrics and Gynecology, AP-HP, Antoine Béclère Hospital, Clamart, France
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  • S. Guitton,

    1. Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
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  • M. V. Senat,

    1. Department of Obstetrics and Gynecology, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
    2. Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development, Villejuif, France
    3. University Paris-Sud, Villejuif, France
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  • F. Fuchs,

    1. Department of Obstetrics and Gynecology, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
    2. Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development, Villejuif, France
    3. University Paris-Sud, Villejuif, France
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  • J. M. Ayoubi,

    1. Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
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  • L. Grangeot Keros,

    1. INSERM U764, Université Paris-Sud, AP-HP, Microbiology Department, Hôpital Antoine Béclère, Clamart, France
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  • A. Benachi

    1. Department of Obstetrics and Gynecology, AP-HP, Antoine Béclère Hospital, Clamart, France
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  • Funding sources: None

  • Conflicts of interest: None declared

Correspondence to: Olivier Picone. E-mail: o.picone@hopital-foch.org

ABSTRACT

Objective

To analyze the outcome of maternal primary cytomegalovirus (CMV) infection.

Methods

Retrospective analysis of a cohort of 238 patients with maternal primary CMV infection detected at routine screening. The cases were managed with serial ultrasound (US) scans, and amniocentesis was performed in 36.1% of cases. All prenatal results were confirmed at birth.

Results

The average age was 31.9 (18–44) years. Patients were symptomatic in 21% of cases. The rate of intrauterine transmission was 24.9%, and it was 8.8%, 19%, 30.6%, 34.1% and 40% in the preconceptional period, the periconceptional period, and the first, second and third trimesters of pregnancy, respectively (p = 0.025). There was a significantly higher risk of US abnormalities when maternal infection occurred during the preconceptional or periconceptional period and the first trimester compared with later (p < 0.001). Because of US abnormalities, pregnancy was terminated in 18 cases at the parents' request. Three infected newborns were symptomatic; all three cases were suspected at US before birth. We did not observe any symptomatic fetal infection when maternal infection occurred after 14 weeks of gestation. A number of clinically asymptomatic cases (5.5%) developed hearing loss.

Conclusion

The rate of materno fetal transmission is linearly correlated to the gestational age at infection. No severe case of congenital infection was observed if maternal infection occurred after 14 weeks of gestation. © 2013 John Wiley & Sons, Ltd.

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