Cytomegalovirus (CMV) infection is a major cause of neonatal malformations in humans, and most CMV infections in children are asymptomatic, with only a few being symptomatic, and most occurring in children with congenital and perinatal infections. The damage to the target organs is related to the age of the child. The prevention of CMV infection in pregnant women is particularly important since all neonatal CMV infections originate in the mother.
Routes of CMV infection in newborns
1. Congenital infection
Maternal CMV infection in pregnancy can invade the fetus through the placenta and cause congenital infection, and in a few cases, it causes preterm birth, miscarriage, stillbirth or death after birth. Jaundice, hepatosplenomegaly, thrombocytopenic purpura and hemolytic anemia can occur in children. Surviving children are often left with permanent mental retardation, neuromuscular motor disorders, deafness, and chorioretinitis optica.
2.Perinatal infection
If CMV is excreted from the maternal urinary tract and cervix, the infant can be infected through the birth canal during delivery, mostly with subclinical bed infection with mild or no clinical symptoms, some with mild whistling tract disorder or liver function impairment.
How to determine CMV infection in pregnant women?
Cytomegalovirus serology, such as cytomegalovirus-specific IgG, IgM antibodies and IgG antibody affinity, is indicated when flu-like symptoms (e.g., fever, fatigue and headache) are present in a pregnant woman and other pathogenic infections can be ruled out.
Serum cytomegalovirus-specific IgG antibody testing is performed if the mother was negative for cytomegalovirus serology prior to pregnancy; diagnosis of primary cytomegalovirus infection in those whose immune status is unclear should be based on the detection of cytomegalovirus-specific IgM antibodies and mild to moderate cytomegalovirus-specific IgG antibody affinity.
Health precautions and behavioral interventions for cytomegalovirus infection in pregnant women
1.Hygienic precautions.
(1) Pregnant women should not eat food eaten by children, avoid drinking beverages drunk by children, and not share utensils with children.
(2) Do not put children’s toys and comfort pacifiers in the mouth.
(3) Avoid touching the saliva of children when kissing them.
2. Behavioral interventions.
Pregnant women should wash their hands adequately with soap, especially after changing children’s diapers, feeding them, wiping their noses or saliva, for 15-20 s. Other measures include washing toys, work surfaces, and surfaces touched by children’s urine or saliva regularly, and not sharing toothbrushes with children, but these measures may have little effect on preventing cytomegalovirus infection in pregnant women.
Prevention of cytomegalovirus infection
1. All pregnant women and health care workers need to be educated about congenital cytomegalovirus infection and its prevention.
Routine use of cytomegalovirus highly potent immunoglobulin to prevent fetal cytomegalovirus infection in pregnant women with existing primary cytomegalovirus infection is not recommended.
3. Routine antiviral therapy during pregnancy is not recommended for the prevention of fetal congenital cytomegalovirus infection.
Treatment of cytomegalovirus infection
1. Routine application of cytomegalovirus high-valent immunoglobulin for fetal congenital cytomegalovirus infection is not recommended.
2. Routine application of antiviral drugs for fetal congenital cytomegalovirus infection during pregnancy is not recommended