Congenital cytomegalovirus infection: recent advances in the diagnosis of maternal infection.
In most European countries, pregnant women are tested for cytomegalovirus (CMV) during the first trimester of pregnancy. Within the last 5 years, European laboratories have made significant progress in solving diagnostic problems linked to infection in pregnancy. With advances in CMV serology, the presence of anti-CMV immunoglobulin (Ig)M detected by a screening test such as enzyme immunoassay, can be confirmed by blot, identifying pregnant women undergoing an active or recent infection. Furthermore, primary infections that were proven if a seroconversion was observed or suspected in the presence of IgM, can now be readily diagnosed by disclosing the presence of anti-CMV low avidity in IgM-positive mothers, greatly reducing the number of women who should be considered at risk of transmitting the virus. Virologic maternal tests are not enough to diagnose a recent primary maternal CMV infection and the detection or quantification of CMV in maternal blood does not seem to be associated with a higher risk for fetal infection. A cohort of 1520 pregnant women considered at risk of transmitting the virus were followed in a longitudinal study at the University of Bologna. Women were identified as part of routine CMV screening in several Italian regions and were IgM-positive for CMV. We documented IgG seroconversion in 83 women and 1437 were IgM-positive by commercial kit.
Lazzarotto
Tiziana
T
Department of Clinical and Experimental Medicine, St. Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy. titti@med.unibo.it
Gabrielli
Liliana
L
Lanari
Marcello
M
Guerra
Brunella
B
Bellucci
Tatiana
T
Sassi
Monica
M
Landini
Maria Paola
MP
D000915:Antibody Affinity / Q000276:immunology; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000151:congenital / Q000175:diagnosis*; D005260:Female; D005333:Fetus / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn / Q000652:urine; D018445:Infectious Disease Transmission, Vertical; D007558:Italy; D008137:Longitudinal Studies; D009504:Neutrophils / Q000737:chemistry / Q000821:virology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters / Q000097:blood / Q000276:immunology; D011296:Prenatal Diagnosis / Q000379:methods*; D012008:Recurrence; D012680:Sensitivity and Specificity; D014766:Viremia / Q000175:diagnosis
D007074:Immunoglobulin G; D007075:Immunoglobulin M