title: Cytomegalovirus: should we screen pregnant women for primary infection?
abstract: Congenital cytomegalovirus (CMV) is a leading cause of neonatal morbidity, affecting ~0.5 to 1% of infants born each year. Primary maternal infection during early pregnancy is the greatest risk factor for severe neonatal morbidity/mortality. The current recommendation from national organizations advises against routine screening of pregnant women for primary infection. Recent advancements in diagnosis and treatment raise the issue of implementation of a national screening program. Prior to development of a major screening program for a highly prevalent and costly disease, the screening test must be safe, reliable, and valid with an effective and feasible intervention. This article reviews recent literature regarding available screening tests and potential interventions and whether criteria for a screening program are met in the current state of science. Although screening women using CMV immunoglobulin (Ig) G, IgM, and IgG avidity testing is reliable, effective intervention with hygiene modification or treatment with CMV-specific hyperimmune globulin is not as well established. More evidence from randomized controlled trials is needed prior to moving forward with a screening program for congenital CMV.
authors.affiliation: Department of Obstetrics and Gynecology, Women and Infants Hospital/Brown University, Providence, RI 02905, USA. jujohnson@wihri.org
authors.forename: Julie M
authors.initials: JM
authors.lastname: Johnson
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Anderson
mesh_terms: D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening / Q000592:standards; D010353:Patient Education as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000517:prevention & control / Q000821:virology
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; C045781:cytomegalovirus-specific hyperimmune globulin