title: Preconception screening for cytomegalovirus: an effective preventive approach.
abstract: Congenital cytomegalovirus (CMV) is the leading infectious cause of sensorineural hearing loss and delayed psychomotor development. Viral transmission to the fetus is far more likely to occur following a primary than a secondary maternal infection. Primary prevention seems to be the best means to reduce the burden of congenital CMV due to the lack of treatment options during pregnancy. We evaluated this approach on a cohort of 500 women planning pregnancy who attended our fertility clinic. Of the 444 who underwent CMV screening, 18 (4.1%) had positive IgM serology for CMV; of these, IgG avidity was high in 12 (remote infection) and low in 6 (recent infection). The latter were advised to delay pregnancy. All women who were seroimmune for CMV (366/444, 82.4%), including the 12 with remote infection, continued fertility treatment. The remaining patients (72/444, 16.2%), who were not immune to CMV at the initial screen, were advised to minimize CMV exposure by improving personal hygiene and to continue fertility treatment. None of the 69/72 (95.8%) women who were followed for one year were infected with CMV. Cytomegalovirus testing and counselling at preconception seemed effective in reducing CMV exposure in pregnancy.
authors.affiliation: Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Reichman
authors.affiliation: Clalit Health Services, Jerusalem, Israel ; Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
authors.forename: Ian
authors.identifier: 0000-0002-5654-0669
authors.initials: I
authors.lastname: Miskin
authors.affiliation: Departments of Anesthesiology and Critical Care, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
authors.forename: Limor
authors.initials: L
authors.lastname: Sharoni
authors.affiliation: Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Eldar-Geva
authors.affiliation: Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Goldberg
authors.affiliation: Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Avi
authors.identifier: 0000-0003-2676-3877
authors.initials: A
authors.lastname: Tsafrir
authors.affiliation: Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Michael
authors.identifier: 0000-0001-9863-7904
authors.initials: M
authors.lastname: Gal
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification* / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000097:blood* / Q000276:immunology / Q000821:virology; D005260:Female; D005333:Fetus / Q000276:immunology / Q000821:virology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M