Neonatal HCMV-related polymicrogyria in seroimmune women

What is the optimal pregnancy management?

Research output: Contribution to journalArticle

Abstract

Background: Human cytomegalovirus (HCMV) infection is the most common congenital infection in developed countries. Recent studies highlighted similar percentages of symptoms in HCMV congenitally-infected infants following either primary or non-primary maternal infections. Objectives: To highlight correlation between neonatal brain abnormalities, detected by ultrasounds and magnetic resonance image in HCMV congenitally-infected infants, and maternal virological parameters during pregnancy, especially in seroimmune mothers. Study design: We considered the 36 HCMV congenitally-infected infants (26 asymptomatic and 10 symptomatic) referred to our center over 4 consecutive years. Maternal serologic data during pregnancy were available for all cases. Neonatal cranial ultrasound and magnetic resonance images were related to maternal virological findings during pregnancy. Results: Polymicrogyria was observed in 6/10 (60.0%) symptomatic and 0/26 (0%) asymptomatic newborns (p < 0.001). The 6 infants with polymicrogyria were all born to mothers who were HCMV IgG reactive with negative specific IgM, in the first trimester of pregnancy (range: 8–14 weeks). For these six women, pre-conceptional HCMV serologic information were absent and they all were considered immune for HCMV during pregnancy, therefore no further serologic investigation or specific educational and hygienic information were recommended during gestation. Conclusion: These data highlight the elevated frequency of polymicrogyria in HCMV congenitally-infected infants born to mothers defined as seroimmune in the early stage of pregnancy and having no pre-existing serologic information. The paper stresses the potential utility of pre-conceptional screening to define maternal infection reliably (primary vs non-primary), and allow evidence-based counseling in women with positive serology, suggesting also preventive hygienic measures during pregnancy.

Original languageEnglish
Pages (from-to)141-146
Number of pages6
JournalJournal of Clinical Virology
Volume108
DOIs
Publication statusPublished - Nov 1 2018

Fingerprint

Cytomegalovirus
Mothers
Pregnancy
Magnetic Resonance Spectroscopy
Infection
Polymicrogyria
Cytomegalovirus Infections
Serology
First Pregnancy Trimester
Developed Countries
Immunoglobulin M
Counseling
Immunoglobulin G
Newborn Infant
Brain

Keywords

  • Cytomegalovirus congenital infection
  • Maternal immunity
  • Polymicrogyria
  • Pregnancy

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

@article{08e4fd09cb004b61a191c56621a3dbfb,
title = "Neonatal HCMV-related polymicrogyria in seroimmune women: What is the optimal pregnancy management?",
abstract = "Background: Human cytomegalovirus (HCMV) infection is the most common congenital infection in developed countries. Recent studies highlighted similar percentages of symptoms in HCMV congenitally-infected infants following either primary or non-primary maternal infections. Objectives: To highlight correlation between neonatal brain abnormalities, detected by ultrasounds and magnetic resonance image in HCMV congenitally-infected infants, and maternal virological parameters during pregnancy, especially in seroimmune mothers. Study design: We considered the 36 HCMV congenitally-infected infants (26 asymptomatic and 10 symptomatic) referred to our center over 4 consecutive years. Maternal serologic data during pregnancy were available for all cases. Neonatal cranial ultrasound and magnetic resonance images were related to maternal virological findings during pregnancy. Results: Polymicrogyria was observed in 6/10 (60.0{\%}) symptomatic and 0/26 (0{\%}) asymptomatic newborns (p < 0.001). The 6 infants with polymicrogyria were all born to mothers who were HCMV IgG reactive with negative specific IgM, in the first trimester of pregnancy (range: 8–14 weeks). For these six women, pre-conceptional HCMV serologic information were absent and they all were considered immune for HCMV during pregnancy, therefore no further serologic investigation or specific educational and hygienic information were recommended during gestation. Conclusion: These data highlight the elevated frequency of polymicrogyria in HCMV congenitally-infected infants born to mothers defined as seroimmune in the early stage of pregnancy and having no pre-existing serologic information. The paper stresses the potential utility of pre-conceptional screening to define maternal infection reliably (primary vs non-primary), and allow evidence-based counseling in women with positive serology, suggesting also preventive hygienic measures during pregnancy.",
keywords = "Cytomegalovirus congenital infection, Maternal immunity, Polymicrogyria, Pregnancy",
author = "Maurizio Zavattoni and Giuseppina Lombardi and Francesca Garofoli and Guido Scalia and Annalisa Rizzo and Micol Angelini and Antonella Sarasini and Milena Furione and Fausto Baldanti",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.jcv.2018.10.001",
language = "English",
volume = "108",
pages = "141--146",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
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TY - JOUR

T1 - Neonatal HCMV-related polymicrogyria in seroimmune women

T2 - What is the optimal pregnancy management?

AU - Zavattoni, Maurizio

AU - Lombardi, Giuseppina

AU - Garofoli, Francesca

AU - Scalia, Guido

AU - Rizzo, Annalisa

AU - Angelini, Micol

AU - Sarasini, Antonella

AU - Furione, Milena

AU - Baldanti, Fausto

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Human cytomegalovirus (HCMV) infection is the most common congenital infection in developed countries. Recent studies highlighted similar percentages of symptoms in HCMV congenitally-infected infants following either primary or non-primary maternal infections. Objectives: To highlight correlation between neonatal brain abnormalities, detected by ultrasounds and magnetic resonance image in HCMV congenitally-infected infants, and maternal virological parameters during pregnancy, especially in seroimmune mothers. Study design: We considered the 36 HCMV congenitally-infected infants (26 asymptomatic and 10 symptomatic) referred to our center over 4 consecutive years. Maternal serologic data during pregnancy were available for all cases. Neonatal cranial ultrasound and magnetic resonance images were related to maternal virological findings during pregnancy. Results: Polymicrogyria was observed in 6/10 (60.0%) symptomatic and 0/26 (0%) asymptomatic newborns (p < 0.001). The 6 infants with polymicrogyria were all born to mothers who were HCMV IgG reactive with negative specific IgM, in the first trimester of pregnancy (range: 8–14 weeks). For these six women, pre-conceptional HCMV serologic information were absent and they all were considered immune for HCMV during pregnancy, therefore no further serologic investigation or specific educational and hygienic information were recommended during gestation. Conclusion: These data highlight the elevated frequency of polymicrogyria in HCMV congenitally-infected infants born to mothers defined as seroimmune in the early stage of pregnancy and having no pre-existing serologic information. The paper stresses the potential utility of pre-conceptional screening to define maternal infection reliably (primary vs non-primary), and allow evidence-based counseling in women with positive serology, suggesting also preventive hygienic measures during pregnancy.

AB - Background: Human cytomegalovirus (HCMV) infection is the most common congenital infection in developed countries. Recent studies highlighted similar percentages of symptoms in HCMV congenitally-infected infants following either primary or non-primary maternal infections. Objectives: To highlight correlation between neonatal brain abnormalities, detected by ultrasounds and magnetic resonance image in HCMV congenitally-infected infants, and maternal virological parameters during pregnancy, especially in seroimmune mothers. Study design: We considered the 36 HCMV congenitally-infected infants (26 asymptomatic and 10 symptomatic) referred to our center over 4 consecutive years. Maternal serologic data during pregnancy were available for all cases. Neonatal cranial ultrasound and magnetic resonance images were related to maternal virological findings during pregnancy. Results: Polymicrogyria was observed in 6/10 (60.0%) symptomatic and 0/26 (0%) asymptomatic newborns (p < 0.001). The 6 infants with polymicrogyria were all born to mothers who were HCMV IgG reactive with negative specific IgM, in the first trimester of pregnancy (range: 8–14 weeks). For these six women, pre-conceptional HCMV serologic information were absent and they all were considered immune for HCMV during pregnancy, therefore no further serologic investigation or specific educational and hygienic information were recommended during gestation. Conclusion: These data highlight the elevated frequency of polymicrogyria in HCMV congenitally-infected infants born to mothers defined as seroimmune in the early stage of pregnancy and having no pre-existing serologic information. The paper stresses the potential utility of pre-conceptional screening to define maternal infection reliably (primary vs non-primary), and allow evidence-based counseling in women with positive serology, suggesting also preventive hygienic measures during pregnancy.

KW - Cytomegalovirus congenital infection

KW - Maternal immunity

KW - Polymicrogyria

KW - Pregnancy

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U2 - 10.1016/j.jcv.2018.10.001

DO - 10.1016/j.jcv.2018.10.001

M3 - Article

VL - 108

SP - 141

EP - 146

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

SN - 1386-6532

ER -