title: Symptomatic congenital cytomegalovirus disease following non-primary maternal infection: a retrospective cohort study.
abstract: Scarce data exist about screening, diagnosis and prognosis of non-primary Cytomegalovirus (CMV) during pregnancy. We aimed to examine antenatal diagnosis of maternal non-primary CMV infection and to identify risk factors for congenial CMV disease.
  
  
  
  Retrospective cohort of 107 neonates with congenital symptomatic CMV infection, following either primary (n = 95) or non-primary (n = 12) maternal CMV infection. We compared the groups for the manifestations and severity of congenial CMV disease, as well as for possible factors associated with the risk of developing CMV related infant morbidity.
  
  
  
  Disease severity is not similar in affected newborns, with a higher incidence of abnormal brain sonographic findings, following primary versus non-primary maternal CMV infection (76.8% vs. 8.3%, p < .001). Symptomatic congenital CMV disease following a non-primary infection is more frequent if gestational hypertensive disorders and/or gestational diabetes mellitus have ensued during pregnancy (33.3% vs. 9.9%, p <0.038), as well as if any medications were taken throughout gestation (50% vs. 16.8%, p <0.016). CMV-IgM demonstrates a low detection rate for non-primary maternal infection during pregnancy compared to primary infection (25% vs. 75.8%, p = 0.0008).
  
  
  
  Non-primary maternal CMV infection has an impact on the neonate. Although not readily diagnosed during pregnancy, knowledge of risk factors may aid in raising clinical suspicion.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, 39 Zabotinski St., Petach-Tikva, 49100, Israel. eranh42@gmail.com.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. eranh42@gmail.com.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Dorfman
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, 39 Zabotinski St., Petach-Tikva, 49100, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Bardin
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, 39 Zabotinski St., Petach-Tikva, 49100, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Pediatrics C Department, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, 39 Zabotinski St., Petach-Tikva, 49100, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Pardo
mesh_terms: D000328:Adult; D001921:Brain / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000196:embryology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal
keywords: Congenital; Cytomegalovirus; Diagnosis; Non-primary; Risk factors; Secondary