title: Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy.
abstract: Congenital cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital cytomegalovirus. Data in the literature suggest that congenital cytomegalovirus infection remains a research priority, but data are yet to be translated into clinical practice. An informal International Congenital Cytomegalovirus Recommendations Group was convened in 2015 to address these questions and to provide recommendations for prevention, diagnosis, and treatment. On the basis of consensus discussions and a review of the literature, we do not support universal screening of mothers and the routine use of cytomegalovirus immunoglobulin for prophylaxis or treatment of infected mothers. However, treatment guidelines for infected neonates were recommended. Consideration must be given to universal neonatal screening for cytomegalovirus to facilitate early detection and intervention for sensorineural hearing loss and developmental delay, where appropriate. The group agreed that education and prevention strategies for mothers were beneficial, and that recommendations will need continual updating as further data become available.
authors.affiliation: Serology & Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, NSW, Australia; School of Medical Sciences, University of New South Wales, NSW, Australia; School of Biotechnology and Biomolecular Sciences, University of New South Wales, NSW, Australia. Electronic address: w.rawlinson@unsw.edu.au.
authors.forename: William D
authors.initials: WD
authors.lastname: Rawlinson
authors.affiliation: Department of Pediatrics & Microbiology, University of Alabama at Birmingham, AL, USA.
authors.forename: Suresh B
authors.initials: SB
authors.lastname: Boppana
authors.affiliation: Department of Pediatrics & Microbiology, University of Alabama at Birmingham, AL, USA.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Fowler
authors.affiliation: Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, AL, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Kimberlin
authors.affiliation: Operative Unit of Clinical Microbiology, Laboratory of Virology, Polyclinic St. Orsola-Malpighi, Department of Specialised Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lazzarotto
authors.affiliation: National Reference Center for Cytomegalovirus, CHU Limoges, Laboratoire de Bactériologie-Virologie, Université de Limoges, Limoges, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Alain
authors.affiliation: Congenital Cytomegalovirus Association, NSW, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Daly
authors.affiliation: National Cytomegalovirus Foundation, Tampa, FL, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Doutré
authors.affiliation: Departments of Medicine and Pediatrics, Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, MA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Gibson
authors.affiliation: Department of Obstetrics and Gynaecology and Department of Infectious Diseases, Monash University, VIC, Australia.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Giles
authors.affiliation: National Cytomegalovirus Foundation, Tampa, FL, USA.
authors.forename: Janelle
authors.initials: J
authors.lastname: Greenlee
authors.affiliation: Serology & Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, NSW, Australia.
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Hamilton
authors.affiliation: Department of Pediatrics and Pathology & Immunology, Baylor College of Medicine, TX, USA.
authors.forename: Gail J
authors.initials: GJ
authors.lastname: Harrison
authors.affiliation: Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, VIC, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, VIC, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hui
authors.affiliation: Marie Bashir Institute for Infectious Diseases and Biosecurity, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia; The Children's Hospital, Westmead, NSW, Australia.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Jones
authors.affiliation: School of Women's and Child Health, University of New South Wales, NSW, Australia; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, NSW, Australia.
authors.forename: Pamela
authors.initials: P
authors.lastname: Palasanthiran
authors.affiliation: Center for Infectious Diseases and Microbiology Translational Research, Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, MN, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Schleiss
authors.affiliation: Menzies School Health Policy, University of Sydney, Sydney, NSW, Australia; Department of Maternal Fetal Medicine, Royal Hospital for Women, Sydney, NSW, Australia.
authors.forename: Antonia W
authors.initials: AW
authors.lastname: Shand
authors.affiliation: Serology & Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, NSW, Australia; School of Medical Sciences, University of New South Wales, NSW, Australia.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: van Zuylen
mesh_terms: D000013:Congenital Abnormalities / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy / Q000635:transmission; D002658:Developmental Disabilities / Q000517:prevention & control; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000151:congenital / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000517:prevention & control