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. 2024 Sep 30;16(10):1552.
doi: 10.3390/v16101552.

Intrauterine Fetal Demise, Spontaneous Abortion and Congenital Cytomegalovirus: A Systematic Review of the Incidence and Histopathologic Features

Megan H Pesch  1 , Jonathan Mowers  2 , Anh Huynh  3 , Mark R Schleiss  4
Affiliations

Intrauterine Fetal Demise, Spontaneous Abortion and Congenital Cytomegalovirus: A Systematic Review of the Incidence and Histopathologic Features

Megan H Pesch et al. Viruses. .

Abstract

The objective was to review the existing literature reporting on spontaneous abortion (SA) and intrauterine fetal demise (IUFD) associated with cytomegalovirus (CMV) infection. A review using standardized terminology such as 'intrauterine fetal death', 'congenital cytomegalovirus' and 'CMV' was performed using PubMed and Embase (Medline) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Twenty-one studies met inclusion criteria. CMV was identified as a potential or likely factor in a median of 7.1% of SA or IUFD in study cohorts. Of the studies, 11 used fetal remains, 18 used placenta, 6 used serum, and 1 used post-mortem dried blood spot as specimens for testing for CMV. Features commonly observed were fetal thrombotic vasculopathy, hydrops fetalis and chronic villitis. CMV is frequently noted in studies evaluating viral etiologies of SA or IUFD. Large population-based studies are needed to estimate the incidence of CMV-associated SA or IUFD. CMV and congenital CMV should be included on the differential diagnosis in all cases of SA or IUFD of unknown etiology.

Keywords: congenital cytomegalovirus; cytomegalovirus; intrauterine fetal demise; placenta; spontaneous abortion; stillbirth.

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Conflict of interest statement

M.H.P. serves on the board of directors of the National CMV Foundation, and is a consultant for MedScape/Web MD, Diasorin and Moderna. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA diagram from search.
Figure 2
Figure 2
Box plots of CMV positivity rates of tissues from intrauterine fetal demise or spontaneous abortion for studies included in the systematic review. (a) CMV Positivity Rate (%) for all entire corpus of studies (n = 21). (b) CMV Positivity Rate (%) by gestational age of pregnancy loss as categorized by each study (n = 21).
See this image and copyright information in PMC

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