Cytomegalovirus infection during pregnancy

Abstract

Cytomegalovirus (CMV) infection during pregnancy is a global silent problem. Additionally, it is the leading cause of congenital infections, non-genetic sensorineural hearing loss, and neurodevelopmental delays in infants. However, this has barely been recognized globally. This condition lacks adequate attention, which is further emphasized by the lack of awareness among healthcare workers and the general population. The impact of CMV infection is often overlooked because of the asymptomatic nature of its presentation in infected pregnant women and newborns, difficulty in diagnosis, and the perception that infants born to women with pre-existing antibodies against CMV have normal neonatal outcomes. This article highlights the latest information on the epidemiology, transmission, clinical manifestations, and development of CMV infection and its management. We reviewed the pathophysiology and clinical manifestations of CMV infection in pregnant women, diagnostic methods, including screening and prognostic markers, and updates in treatment modalities. Current advancements in research on vaccination and hyperimmunoglobulins with worldwide treatment protocols are highlighted.

Keywords: Acyclovir; Cytomegalovirus; Hearing loss; Microcephaly; Pregnancy; Valacyclovir.

Fig. 1

Transmission mechanisms and treatment protocols for CMV infection during pregnancy. CMV, cytomegalovirus; MCP-1, monocyte chemoattractant protein-1; TNF-α, tumor necrosis factor alpha; IUGR, intrauterine growth restriction; IgG, immunoglobulin G; IgM, immunoglobulin M; RT-PCR, reverse transcription polymerase chain reaction; MRI, magnetic resonance imaging; CNS, central nervous system.

Fig. 2

Flow chart for the interpretation of the maternal cytomegalovirus (CMV) serology test results. IgG, immunoglobulin G; IgM, immunoglobulin M.