Can measurement of maternal anti-cytomegalovirus immunoglobulin-M antibody levels be used to screen for cytomegalovirus infection in embryos and fetuses?
OBJECTIVE
Our study aims to estimate whether measurement of maternal anti-cytomegalovirus immunoglobulin-M antibody (CMV-IgM) levels are useful as a screening method for achieving early detection of congenital CMV infection.


METHODS
Levels of maternal CMV-IgM were measured by enzyme immunoassay in all (n =2865) pregnant women who visited our hospital in the first trimester during the period from January 2005 to December 2009.


RESULTS
Among them, 21 individuals (0.73%) had a CMV-IgM titer of ≥0.08 and were judged to be CMV-IgM-positive. Informed consent was obtained from all 21 individuals to perform the confirmation test that quantifies the levels of cytomegalovirus DNA (CMV-DNA) in amniotic fluid by real-time polymerase chain reaction. However, only one (0.03%) of the 21 individuals was CMV-DNA-positive (CMV-DNA concentration, 1.0 × 10(4) copies/ml).


CONCLUSIONS
In order to detect congenital CMV infection in early pregnancy, it is considered appropriate to use ultrasound for close examination of embryo or fetal symptoms indicative of CMV instead of performing serological screening based on CMV-IgM.
Department of Obstetrics and Gynecology, National Defense Medical College Division of Obstetrics and Gynecology, Matsuda Perinatal Clinic Division of Obstetrics and Gynecology, Self-Defense Forces Central Hospital, Tokorozawa, Japan. dr22023@ndmc.ac.jp
Masashi
M
Yoshida
Hideo
H
Matsuda
Yosuke
Y
Yoshinaga
Kazuhiko
K
Asai
Akihiro
A
Kawashima
Kiguna
K
Sei
Kenichi
K
Furuya
D000328:Adult; D000653:Amniotic Fluid / Q000276:immunology; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis*; D000914:Antibodies, Viral / Q000032:analysis*; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology / Q000635:transmission; D005260:Female; D005333:Fetus; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000276:immunology / Q000821:virology
D000888:Antibodies, Anti-Idiotypic; D000914:Antibodies, Viral; D007075:Immunoglobulin M; C044203:anti-IgM