Seroepidemiological survey of cytomegalovirus infection among pregnant women in Nagasaki, Japan.
BACKGROUND
Epidemiology of cytomegalovirus (CMV) infection varies widely, depending on ethnicity and socioeconomic status. A seroepidemiological survey was conducted to determine CMV infection among pregnant women in Nagasaki Prefecture, Japan.


METHODS
We measured serum CMV-specific immunoglobulin (Ig) M and IgG at the first and third trimesters. IgG avidity was determined when both CMV-IgG and CMV-IgM were positive.


RESULTS
Of 339 pregnant women, 296 (87.3%) were CMV-IgG-positive at the first trimester. Of 267 paired sera, one (0.37%) had CMV-IgG seroconversion, another one (0.37%) had CMV-IgM seroconversion, and 12 had both CMV-IgG and CMV-IgM, two (0.75%) of whom had low IgG avidity, suggesting recent infection. Thus, the incidence of primary CMV infection during pregnancy was 0.74-1.5%. Assuming the rate of in utero transmission following maternal primary infection to be approximately 40%, the incidence of congenital infection is estimated to be 0.3-0.6%.


CONCLUSIONS
Although CMV seroprevalence among pregnant women has been decreasing in industrialized regions including other parts of Japan, CMV-seroprevalence remains high in Nagasaki. Thus, epidemiology of CMV infection seems variable within Japan, a country generally considered to be ethnically and socioeconomically homogeneous. However, 40-80 infants may be congenitally infected and 15-27% (or 6-22) of them may ultimately suffer from certain neurological sequelae annually in Nagasaki Prefecture, so where annual live births are approximately 13,300, congenital CMV infection seems to be a significant public health problem in such an apparently low-risk region as Nagasaki.
Tagawa
Masato
M
Department of Pediatrics, Nagasaki University Hospital, Nagasaki, Japan. mtagawa@air.ocn.ne.jp
Minematsu
Toshio
T
Masuzaki
Hideaki
H
Ishimaru
Tadayuki
T
Moriuchi
Hiroyuki
H
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D007564:Japan / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D014505:Urban Population; D055815:Young Adult
D007074:Immunoglobulin G; D007075:Immunoglobulin M