title: Early primary cytomegalovirus infection in pregnancy: maternal hyperimmunoglobulin therapy improves outcomes among infants at 1 year of age.
abstract: BACKGROUND
  Primary cytomegalovirus (CMV) infection during pregnancy is the leading infectious cause of congenital neurological disabilities. Early CMV infection carries a higher risk of adverse neonatal outcome (sensorineural hearing loss or neurological deficits). Intravenous hyperimmunoglobulin (HIG) therapy seems to be promising, but its efficacy needs further investigation.
  
  
  METHODS
  Since 2002, we have enrolled consecutively all pregnant women with early (ie, before gestational week 17) CMV infection. Beginning in 2007, all women were offered treatment with HIG (200 UI per kilogram of maternal weight, in a single intravenous administration). Outcome of infants was evaluated at the age of 1 year.
  
  
  RESULTS
  Of the 592 women with early primary CMV infection, amniocentesis for CMV DNA detection was performed for 446. Of the 92 CMV-positive fetuses, pregnancy was terminated for 24, HIG was administered to mothers of 31, and no treatment was received by mothers of 37. Fetuses of treated mothers did not differ from fetuses of nontreated mothers according to mother's age, gestational week of infection, CMV load, or detection of abnormal ultrasonography findings. At the 1-year evaluation, 4 of 31 infants with treated mothers (13%; 95% confidence interval [CI], 1%-25%) and 16 of 37 infants with nontreated mothers (43%; 95% CI, 27%-59%) presented with poor outcomes (P < .01, by the 2-tailed Fisher exact test).
  
  
  CONCLUSIONS
  HIG treatment improved the outcome of fetuses from women who had primary CMV infection before gestational week 17.
authors.affiliation: Gynecological Sciences and Human Reproduction, University of Padua, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Visentin
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
authors.forename: Laura
authors.initials: L
authors.lastname: Milanese
authors.forename: Anna
authors.initials: A
authors.lastname: Da Roit
authors.forename: Gabriella
authors.initials: G
authors.lastname: Forner
authors.forename: Eleonora
authors.initials: E
authors.lastname: Salviato
authors.forename: Valentina
authors.initials: V
authors.lastname: Citton
authors.forename: Fioretta Marciani
authors.initials: FM
authors.lastname: Magno
authors.forename: Eva
authors.initials: E
authors.lastname: Orzan
authors.forename: Carla
authors.initials: C
authors.lastname: Morando
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cusinato
authors.forename: Carlo
authors.initials: C
authors.lastname: Mengoli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Palu
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.forename: Roberto
authors.initials: R
authors.lastname: Rinaldi
authors.forename: Erich
authors.initials: E
authors.lastname: Cosmi
authors.forename: Nadia
authors.initials: N
authors.lastname: Gussetti
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000821:virology; D000914:Antibodies, Viral / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000628:therapy* / Q000821:virology; D005260:Female; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D007231:Infant, Newborn; D016595:Misoprostol / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy* / Q000821:virology*; D011446:Prospective Studies
chemical_list: D000914:Antibodies, Viral; D016595:Misoprostol