title: Prediction of Congenital Cytomegalovirus Infection in High-Risk Pregnant Women.
abstract: BACKGROUND
  This prospective study aimed to determine maternal clinical, laboratory, and ultrasound findings that effectively predict the occurrence of congenital cytomegalovirus (CMV) infection (CCI) in high-risk pregnant women.
  
  
  METHODS
  Three hundred CMV immunoglobulin (Ig) M-positive pregnant women were enrolled. The maternal clinical and laboratory findings, including serum CMV IgM and IgG; IgG avidity index (AI); antigenemia assay (C7-HRP); polymerase chain reaction (PCR) for the detection of CMV-DNA in the maternal serum, urine, and uterine cervical secretion; and prenatal ultrasound findings, were evaluated. To determine predictive factors for the occurrence of CCI, logistic regression analyses were performed.
  
  
  RESULTS
  In 22 of the 300 women, CCI was confirmed using PCR for CMV-DNA in newborn urine. Univariate analyses demonstrated that the presence of maternal flu-like symptoms, presence of ultrasound fetal abnormalities, serum titers of CMV IgM, positive results for C7-HRP, CMV IgG AI <40%, and positive PCR results in the uterine cervical secretion were statistically associated with the occurrence of CCI. Multivariable analysis revealed that the presence of ultrasound fetal abnormalities (odds ratio [OR], 31.9; 95% confidence interval [CI], 8.5-120.3; P < .001) and positive PCR results in the uterine cervical secretion (OR, 16.4; 95% CI, 5.0-54.1; P < .001) were independent predictive factors of CCI in CMV IgM-positive women.
  
  
  CONCLUSIONS
  This is the first prospective cohort study to suggest that the presence of CMV-DNA in the maternal uterine cervical secretion and ultrasound fetal abnormalities are predictive of the occurrence of congenital CMV infection in high-risk pregnant women.
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanimura
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tairaku
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe; and.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morioka
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagamata
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Kana
authors.initials: K
authors.lastname: Deguchi
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Morizane
authors.affiliation: Department of Obstetrics and Gynecology, and.
authors.forename: Masashi
authors.initials: M
authors.lastname: Deguchi
authors.affiliation: Research Center for Disease Control, Aisenkai Nichinan Hospital, Miyazaki, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Minematsu
authors.affiliation: Department of Obstetrics and Gynecology, and yhideto@med.kobe-u.ac.jp.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D015415:Biomarkers; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000209:etiology* / Q000635:transmission*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: PCR for CMV-DNA; congenital infection; cytomegalovirus; pregnancy; ultrasound examination.