Umbilical cord blood screening for cytomegalovirus DNA by quantitative PCR.
BACKGROUND
Cytomegalovirus (CMV) infection, which is the most common congenitally transmitted infection, affects approximately 1% of neonates worldwide. Despite its prevalence, no convenient screening test for neonatal CMV infection has been implemented.


OBJECTIVE
The purpose of this pilot study was to evaluate the feasibility and yield of screening umbilical cord blood for CMV DNA emiaby quantitative PCR.


METHODS
Umbilical cord blood was tested for CMV DNAemia using a commercial quantitative PCR assay. Maternal CMV serostatus at the time of delivery was assessed by testing for CMV IgG and IgM antibodies in serum.


CONCLUSIONS
Screening for congenital CMV infection with PCR is easily incorporated into routine labor and delivery care using discarded cord blood specimens to identify neonates whose infection is otherwise undiagnosed. Among 433 infants tested, two (0.5%) had DNAemia detected in cord blood, one of whom was symptomatic, and both of whose mothers were CMV IgG positive and IgM negative. Viremic neonates identified by screening with PCR may be at high risk of developing long-term neurological complications of CMV infection and cannot reliably be identified using clinical presentation or maternal serology. Because of its convenience, cord blood CMV screening with PCR should be further investigated for incorporation into neonatal screening protocols.
Theiler
Regan N
RN
Department of Gynecology and Obstetrics, Emory University at Grady Health Systems, 69 Jesse Hill Jr Drive, Atlanta, GA 30303, USA. rtheile@emory.edu
Caliendo
Angela M
AM
Pargman
Sabine
S
Raynor
B Denise
BD
Berga
Sarah
S
McPheeters
Melissa
M
Jamieson
Denise J
DJ
D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000517:prevention & control / Q000635:transmission; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods / Q000592:standards; D016133:Polymerase Chain Reaction; D011296:Prenatal Diagnosis / Q000379:methods; D012698:Serologic Tests / Q000592:standards*
D000914:Antibodies, Viral; D004279:DNA, Viral