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Review
. 2024 Nov 22:78:102941.
doi: 10.1016/j.eclinm.2024.102941. eCollection 2024 Dec.

Current evidence gaps to support systematic cytomegalovirus screening in pregnancy

Agathe Billette de Villemeur  1 , Bruno Hoen  1   2 , Eric Billaud  3 , Philippe Deruelle  4 , Karine Goueslard  5 , Virginie Halley des Fontaines  1 , Philippe Minodier  6 , Bertrand Parent  7   8 , Bruno Pozzetto  9   10 , Matthieu Revest  11   12 , Louis-Rachid Salmi  13   14
Affiliations
Review

Current evidence gaps to support systematic cytomegalovirus screening in pregnancy

Agathe Billette de Villemeur et al. EClinicalMedicine. .

Abstract

The benefits of screening for cytomegalovirus (CMV) infection during pregnancy remain a topic of debate. To date, no randomized trial has compared the impact of screening versus routine management on the prevention of severe sequelae in newborns. Furthermore, it is unclear what actions can be taken in case of a positive screening given that there is limited evidence of effective interventions as no treatments showed significant effect on the frequency of congenital cytomegalovirus infections and, as additional challenge, the window for effective treatment initiation after maternal infection is narrow, estimated to be as short as five weeks. Universal screening of all pregnant women could lead to a high number of false positives. There are also concerns regarding the cost-effectiveness of universal screening and the capacity of healthcare professionals that may struggle to manage the increased workload, and we argue that the conditions for implementing such a programme are not yet met. In this Viewpoint we aim at highlighting these challenges and stimulating the forthcoming discussion on how to fill the gaps before CMV screening in pregnancy could be adopted as a standard practice.

Keywords: Congenital cytomegalovirus infection; Cytomegalovirus infections; Systematic screening; Valacyclovir.

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Conflict of interest statement

EB received support for attending conferences from MSD, Gilead and ViiV; PD received honoraria for lectures by Norgine and Exeltis, and for manuscript writing by Biocodex and a grant from the Ministry of Health for the ePPOP id study. The rest of the authors declare no conflict of interests.

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