Congenital cytomegalovirus infection is associated with high maternal socio-economic status and corresponding low maternal cytomegalovirus seropositivity

Authors

  • James Basha,

    1. Virology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia
    2. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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    • Joint first authors
  • Jenna M Iwasenko,

    1. Virology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia
    2. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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    • Joint first authors
  • Peter Robertson,

    1. Serology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia
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  • Maria E Craig,

    1. School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
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  • William D Rawlinson

    Corresponding author
    1. Virology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia
    2. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
    3. ACPS, SOMS and BABS, University of New South Wales, Kensington, New South Wales, Australia
    • Correspondence: Professor William Rawlinson, Virology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, NSW 2031, Australia. Fax: +61 2 9382 8533; email: w.rawlinson@unsw.edu.au

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  • Conflict of interest: None declared.

Abstract

Aims

Human cytomegalovirus (CMV) is the leading infectious cause of congenital infection in developed countries. Globally, CMV seropositivity has been associated with low socio-economic status (SES); however, Australian data are lacking. Therefore, we examined the association between SES and CMV seroprevalence in children and pregnant women.

Methods

Three groups were examined: 1, a prospective cohort of Australian children aged 0–15 years (n = 220); 2, a clinic-based sample of pregnant women (n = 778); and 3, a case series of infants and children (n = 219) with symptomatic congenital CMV infection. SES was determined using a postcode-based score from the Australian Bureau of Statistics.Group 1 was recruited from endocrinology clinics and follow-up at Prince of Wales Hospital and Children's Hospital at Westmead. Group 2 was recruited at the Royal Hospital for Women. Congenitally infected infants were identified through the Australian Paediatric Surveillance Unit.

Results

CMV seroprevalence among all children was 20% (95% confidence interval (CI) 15–25%), and there was no association with SES (P = 0.58). Seroprevalence among pregnant women was 57% (53–60%), and higher rates of CMV seropositivity were associated with lower SES (P < 0.001). More congenital CMV cases were reported in the highest socio-economic groups (55%) than the lowest (9%) (P < 0.001).

Conclusions

A marked socio-economic gradient in CMV seroprevalence is evident in Australian pregnant women and cases of congenital CMV but not in unselected Australian children. These findings highlight the importance of a community-wide approach to CMV awareness and the potential for hygienic measures to reduce the burden of congenital CMV in Australia.

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