title: Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is the most prevalent congenital viral infection and thus places an enormous disease burden on newborn infants. Seroprevalence of maternal antibodies to CMV due to CMV exposure prior to pregnancy is currently the most important protective factor against congenital CMV disease. The aim of this study was to identify potential predictors, and to develop and evaluate a risk-predicting model for the maternal CMV serostatus in early pregnancy.
  
  
  METHODS
  Maternal and paternal background information, as well as maternal CMV serostatus in early pregnancy from 882 pregnant women were analyzed. Women were divided into two groups based on their CMV serostatus, and were compared using univariate analysis. To predict serostatus based on epidemiological baseline characteristics, a multiple logistic regression model was calculated using stepwise model selection. Sensitivity and specificity were analyzed using ROC curves. A nomogram based on the model was developed.
  
  
  RESULTS
  646 women were CMV seropositive (73.2%), and 236 were seronegative (26.8%). The groups differed significantly with respect to maternal age (p = 0.006), gravidity (p<0.001), parity (p<0.001), use of assisted reproduction techniques (p = 0.018), maternal and paternal migration background (p<0.001), and maternal and paternal education level (p<0.001). ROC evaluation of the selected prediction model revealed an area under the curve of 0.83 (95%CI: 0.8-0.86), yielding sensitivity and specificity values of 0.69 and 0.86, respectively.
  
  
  CONCLUSIONS
  We identified predictors of maternal CMV serostatus in early pregnancy and developed a risk-predicting model based on baseline epidemiological characteristics. Our findings provide easy accessible information that can influence the counseling of pregnant woman in terms of their CMV-associated risk.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Kuessel
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Husslein
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Julian
authors.initials: J
authors.lastname: Marschalek
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Brunner
authors.affiliation: Section for Medical Statistics, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Department of Virology, Medical University of Vienna, Vienna, Austria.
authors.forename: Theresia
authors.initials: T
authors.lastname: Popow-Kraupp
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Kiss
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000378:metabolism*; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000276:immunology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000276:immunology; D037841:Pregnant People; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral