title: Rapid increase in the serum Cytomegalovirus IgG avidity index in women with a congenitally infected fetus.
abstract: BACKGROUND
  Human Cytomegalovirus (CMV) is the virus most frequently responsible for severe diseases of the fetus and newborn. The reported intrauterine transmission rate of CMV following primary maternal infection is approximately 40%. Invasive techniques are needed for the prenatal diagnosis of congenital CMV infection.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether the rapidity of change in the CMV IgG avidity index (AI) is associated with the presence of congenital CMV infection among mothers with suspected primary CMV infection.
  
  
  METHODS
  The serum CMV IgG AI was repeatedly measured in 17 pregnant women with positive or borderline test results for CMV IgM together with an initial IgG AI value of <40%. Their neonates underwent polymerase chain reaction analyses for the presence of CMV DNA in the urine. The rapidity of change in the IgG AI per 4 weeks was defined as the ΔAI (%). The ΔAI of women with congenital CMV infection was compared with that of women with no infection.
  
  
  RESULTS
  The ΔAI of nine mothers with congenital CMV infection (median,15.7%; range,7.8-42.8%) was significantly higher than that of eight mothers with no infection (median, 6.5%, range, 2.0-8.8%; p<0.001). The incidences of congenital CMV infection were 100.0%, 16.7%, and 0.0% among mothers with a ΔAI of >10, 5-10, and <5%, respectively.
  
  
  CONCLUSIONS
  Measurement of the ΔAI in pregnant women might be useful for estimating the risk of mother-to-neonate CMV transmission.
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: ebiyas@med.kobe-u.ac.jp.
authors: Yasuhiko
authors: Y
authors: Ebina
authors: Research Center for Disease Control, Aisenkai Nichinan Hospital, Miyazaki, Japan.
authors: Toshio
authors: T
authors: Minematsu
authors: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Ichiro
authors: I
authors: Morioka
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Masashi
authors: M
authors: Deguchi
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Shinya
authors: S
authors: Tairaku
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Kenji
authors: K
authors: Tanimura
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Ayako
authors: A
authors: Sonoyama
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Satoshi
authors: S
authors: Nagamata
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Mayumi
authors: M
authors: Morizane
authors: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Hideto
authors: H
authors: Yamada
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology*; D000915:Antibody Affinity; D015415:Biomarkers / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000175:diagnosis* / Q000276:immunology / Q000635:transmission; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D044967:Serum / Q000276:immunology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007074:Immunoglobulin G
keywords: Congenital infection; Cytomegalovirus; IgG avidity