Cytomegalovirus infection with habitual non-pregnancy

Intrauterine infection with cytomegalovirus infection is the most common among other infections and occurs in 0.4-2.3% (on average 1%) of all newborns, although this figure varies significantly among different populations.

Many women acquire or reactivate CMV infection during pregnancy, but only a few transmit the virus to their fetuses, with acute or chronic infection developing. Generalized CMV infection in the fetus almost always results from primary infection in the mother, which is usually asymptomatic.

At present, it is impossible to differentiate the damaging effect of virus persistence and/or carriage on the fetus from exacerbation of a latent infection. Virus excretion cannot serve as a reliable indicator, since the virus is excreted with saliva for weeks and months after the primary infection, and it can be detected in urine and the cervical canal after months and even years.

Congenital cytomegalovirus infection of a newborn can lead to deafness, mental retardation, and other neurological disorders.

It is not surprising that many countries conduct programs to screen this infection in pregnant women in order to reduce its consequences for the fetus. The frequency of women with antibodies to cytomegalovirus ranges from 55 to 85%. Antibodies to cytomegalovirus of the IgM and IgG classes do not prevent reactivation of the virus, but their presence in a pregnant woman is extremely important for an obstetrician. The presence of antibodies means that the infection is secondary, and therefore not very dangerous for the fetus.

The diagnosis of "primary cytomegalovirus infection" is extremely difficult to establish. To do this, you need to register all women who do not have antibodies to cytomegalovirus and conduct regular tests at least once a month to catch the moment when antibodies appear. Their appearance will mean that infection has occurred and the patient has become seropositive for cytomegalovirus from seronegative.

In primary cytomegalovirus infection, 30-40% of newborns become ill.

Of these, 10-15% are born with symptoms of the disease, of which 20-30% die. Of those who survive, 90% become disabled and only 10% recover.

In secondary infection or reactivation of infection, 0.2-1% of newborns are born infected. In secondary infection, children do not die, but in 5-10% of cases they can have neurological consequences, 90-95% are healthy. If the child has no symptoms of infection at the time of birth, then 99% of children will be healthy.

Perinatal infection can be acquired transplacentally from mother to fetus, or ascending from the infected cervix through intact membranes. Primary infection is most dangerous in the first and second trimesters of pregnancy, although intrauterine infection can also occur during reactivation, but it proceeds with much less complications for the fetus.

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