Diagnosis and screening for congenital CMV infection in pregnant women in Cuba as prognostic markers of congenital cytomegalovirus in newborns
Abstract number: P1174
Correa C., Kouri V., Verdasquera D., Martinez P.A., Alvarez A., Aleman Y., Perez L., Viera J., Gonzalez R., Perez E., Moro I., Navarro M., Melin P.
Objective: Human cytomegalovirus (HCMV) has established itself as the most significant cause of congenital infection in the developed world, leading to mental and developmental retardation. The objective of this research was to identify pregnant women and newborns at risk of developing congenital infection due to HCMV.
Methods: A diagnostic algorithm utilizing Immunoglobulin G (IgG), IgM, and, IgG avidity was used to prospectively screen serum from 1131 pregnant women enrolled from three municipalities from Havana City, Cuba during 20072008. Qualitative nested PCR and quantitative Real Time-based PCR testing of DNA from urine and saliva were performed on women detected with active infection and their newborn. The identification of different clinical, demographical and epidemiological factors was associated with the virological results, aiming to identify prognostic markers of congenital infection.
Results: The majority of women were seropositive to HCMV (92.7%), with 2.38% (27 women), having active infection (IgM positive or IgG seroconversion). Primary infection was detected in 20 pregnant women (1.77%) while 7 patients (0.62%) had active non primary infection. HCMV DNA was found to be positive in 9 of the 27 pregnant women. CMV congenital infection was diagnosed in 12 (1.06%) of the 26 children born from mothers with active infection, for a vertical transmission rate of 46.2%. Two newborns were symptomatic at birth and two showed sequels during the follow up until 6 month age. It was found that mothers with primary or non-primary active infection had significant risk, RR: 1.11 and RR: 1.16, respectively, to have congenital infected children, furthermore, women with active infection showed significant risk (RR: 1.35) to have congenitally infected children.
Conclusions: It constitutes the first study of diagnosis and screening for congenital HCMV infection in pregnant women and their newborn in Cuba, demonstrating high prevalence rates, although there is an important group of women at risk to acquire infection during pregnancy and produce congenital infection on their offspring. Prenatal diagnosis, and early identification and follow up of congenital CMV infected infants are important for the confirmation and/or definition of the medical conduct with the positive infant, trying to avoid or reducing some possible sequels.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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