Reconsideration of maternal serological testing for predicting congenital CMV infection

Yue Huang; Jiabao Tang; Huan Yu; Qiaoqiao Song; Mengling Hao; Han Wang; Junxian Liu; Yue Dong; Mufeng Liang; Sijie Zhuang; Caihong Li; Jiangding Wang; Caihong Liang; Yingying Su; Tingdong Li; Ting Wu; Shengxiang Ge; Jun Zhang; Ningshao Xia

doi:10.1093/infdis/jiad412

Reconsideration of maternal serological testing for predicting congenital CMV infection

J Infect Dis. 2023 Sep 21:jiad412. doi: 10.1093/infdis/jiad412. Online ahead of print.

Authors

Yue Huang^{1

2}, Jiabao Tang^{1

2}, Huan Yu², Qiaoqiao Song², Mengling Hao², Han Wang², Junxian Liu^{1

2}, Yue Dong^{1

2}, Mufeng Liang^{1

2}, Sijie Zhuang^{1

2}, Caihong Li³, Jiangding Wang⁴, Caihong Liang⁵, Yingying Su^{1

2}, Tingdong Li^{1

2}, Ting Wu^{1

2}, Shengxiang Ge^{1

2}, Jun Zhang^{1

2}, Ningshao Xia^{1

2}

Affiliations

¹ State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China.
² National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Innovation Platform for Industry-Education Integration in Vaccine Research, NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, the Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen 361102, Fujian, China.
³ Xinmi Maternal and Child Health Hospital, Xinmi 452300, Henan, China.
⁴ Jiaxian Maternal and Child Health Hospital, Jiaxian 467100, Henan, China.
⁵ Zhongmu Maternal and Child Health Hospital, Zhongmu 451450, Henan, China.

PMID: 37738651
DOI: 10.1093/infdis/jiad412

Abstract

Background: The value of the widely applied maternal cytomegalovirus (CMV) serological testing approach in predicting intrauterine transmission in highly seroprevalent regions remains unknown.

Methods: A nested case‒control study was conducted based on a maternal-child cohort study. Newborns with congenital CMV (cCMV) infection were included, and each of them was matched to 3 newborns without cCMV infection. Retrospective samples were tested for immunoglobulin G (IgG) avidity and immunoglobulin M (IgM) antibodies in maternal serum and CMV DNA in maternal blood and urine to analyse their associations with cCMV infection.

Results: Forty-eight newborns with cCMV infection and 144 matched newborns without infection were included in the study. Maternal IgM antibodies and IgG avidity during pregnancy were not statistically associated with intrauterine transmission. The presence of CMV DNAemia indicated a higher risk of cCMV infection, with the OR values as 5.7, 6.5 and 13.0 in early, middle and late pregnancy, respectively. However, the difference in CMV shedding rates in transmitters and nontransmitters was not significant in urine.

Conclusion: The value of current maternal CMV serological testing in regions with high seropositivity rates is very limited and should be reconsidered. The detection of DNAemia would be helpful in assessing the risk of intrauterine transmission.

Keywords: Cytomegalovirus; congenital infection; pregnant woman; serology; virology.