2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
9/24/2018 | 11:45 AM - 12:15 PM | Maternal CMV-DNAemia, CMV Hyperimmuneglobulin (HIG), and Neonatal Outcome in Pregnant Women with Primary CMV Infection | Emerald Ballroom I/II
Maternal CMV-DNAemia, CMV Hyperimmuneglobulin (HIG), and Neonatal Outcome in Pregnant Women with Primary CMV Infection
Background. HIG improves neonatal outcome after a primary CMV infection during pregnancy. We studied the association of HIG, maternal CMV-DNAemia, and fetal/neonatal outcome.
Methods. CMV-DNA testing occurred before and after HIG infusions in HIG-treated women, >2 times among HIG untreated patients with positive DNAemia, and only before HIG or once from women with negative DNAemia. HIG groups: 1) 78 women with DNAemia, who had the first HIG infusion 3-19 weeks after maternal infection, and were re-examined within <1 to 7 weeks; 2) 66 women without DNAemia, who had the first HIG infusion 4-16 weeks after infection. Untreated groups: 3) 55women with DNAemia and 4) 84women without initial DNAemia.
Results.The lowest rate of congenital infection was group 2 (HIG-treated, DNA negative) where 10 (14%) of 69 infants were infected. This rate was lower (P < 0.0001) than the 45% rate for 84 untreated women who were DNA negative (group 4) and the 42% rate for 79 infants whose mothers were DNA positive and HIG treated (Group 1). The highest rate (78%) of congenital infection occurred among 55 women who were DNA positive and were untreated. This rate was significantly higher (P<0.00001) than the other 3 groups. At 1 year of age the CMV disease rate was highest (33%) among 36 infected infants born of untreated women with positive DNAemia, and was only 3% in 65 infected infants from HIG-treated women (P<0.01). Resolution of CMV DNAemia was not associated with HIG (P= 0.16) but negative DNA 3 weeks from the first positive DNA occurred in 20 of 54 HIG-treated women (37%) but in none of 8 untreated women (P = 0.045).
Conclusions. In pregnant women with a primary infection maternal viremia predicts neonatal outcome. HIG improved neonatal outcome regardless of initial DNAemia.
- CMV is a serious cause of CMV disease
- Maternal viremia predicts a poor outcome
- HIG is effective for women and their children
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Presenters/Authors
Giovanni Nigro
(), nigrogio@libero.it;
BIOSKETCH OF GIOVANNI NIGRO
Past Director of the Pediatric Unit and School of Pediatrics in the University of L’Aquila, Italy
Specializations: Pediatrics, Infectious Diseases, Gastroenterology
Professional skill: expert in prenatal and postnatal diagnosis and therapy of CMV infection
Author of 348 publications (91 in peer-reviewed journals: Impact Factor 962)
Guest Editor of P.renatal therapy of congenital cytomegalovirus infection. Clin Infect Dis Suppl 4, vol 57, 15 Sept 2015.
Referee for 43 international Journals.
ASHA DISCLOSURE:
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Nonfinancial -
Giovanni Nigro
(), spadler123@gmail.com;
CMV Researcher for several decades
ASHA DISCLOSURE:
Financial -
Nonfinancial -