Immunoglobulin therapy of fetal cytomegalovirus infection occurring in the first half of pregnancy--a case-control study of the outcome in children

J Infect Dis. 2012 Jan 15;205(2):215-27. doi: 10.1093/infdis/jir718. Epub 2011 Dec 2.

Abstract

Background: Primary cytomegalovirus (CMV) infection early in gestation causes severe disease.

Methods: Case patients were 32 congenitally infected children aged 1-5 years who had either hearing deficit and/or psychomotor retardation and whose mothers had a confirmed or probable primary CMV infection at ≤ 20 weeks' gestation. Control subjects were 32 congenitally infected normal children whose mothers had a confirmed primary infection at ≤ 20 weeks' gestation. Case patients and control subjects were matched by the weeks of maternal gestation (± 1 week) at the mother's infection and by the child's age (± 1 year) at evaluation.

Results: For the case patients and control subjects, the mean age was 3.0 years. The mean number of weeks of gestation at maternal infection was 11 weeks. The only risk factor for an affected child was the mother not receiving immunoglobulin (P = .001). Of the 32 case patients, only 4 mothers received CMV immunoglobulin, compared with 27 of the 32 mothers of control infants (adjusted odds ratio, 14 [95% confidence interval, 1.7-110]). The rate of both psychomotor retardation and hearing deficit decreased with immunoglobulin.

Conclusions: These results support the efficacy of immunoglobulins for decreasing the severity of disabilities caused by fetal CMV infection after a primary maternal infection during pregnancy.

MeSH terms

  • Adult
  • Case-Control Studies
  • Child, Preschool
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus*
  • Female
  • Fetal Diseases / drug therapy*
  • Fetal Diseases / virology
  • Hearing Loss / prevention & control
  • Hearing Loss / virology
  • Humans
  • Immunization, Passive*
  • Immunoglobulins / therapeutic use*
  • Infant
  • Logistic Models
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Infectious / virology
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Psychomotor Disorders / prevention & control
  • Psychomotor Disorders / virology
  • Young Adult

Substances

  • Immunoglobulins