Prenatal Cytomegalovirus Infection Discussion
Congenital Cytomegalovirus (CMV) in Newborns and Pregnant Women: What You Need to Know
Cytomegalovirus (CMV), a common viral infection affecting all age groups, is the leading cause of hearing problems or hearing loss in children due to non-genetic reasons. This virus, which belongs to the Herpesviridae family, can pose significant health risks, particularly for newborns and pregnant women.
Health Risks and Symptoms in Newborns
Congenital CMV (cCMV) can cause a range of potential health risks and symptoms, varying from mild to severe. The most common long-term complication is sensorineural hearing loss, which can affect both symptomatic and asymptomatic infants. Other serious complications and symptoms include neurodevelopmental delays, vision problems, microcephaly, enlarged liver and spleen, jaundice, skin rash, high neonatal mortality rate, and other organ involvement like brain, lung, and growth problems.
Approximately 10-20% of babies with cCMV show symptoms at birth, but asymptomatic babies may later develop complications such as hearing loss or neuromotor disabilities. Regular hearing and vision screening is recommended for infants diagnosed with cCMV due to the risk of progressive complications. Antiviral treatment may be considered for symptomatic newborns to reduce long-term impacts.
Symptoms in Pregnant Women
Many pregnant women do not show symptoms even if infected. However, if infected for the first time during pregnancy (primary infection), there's a risk of transmitting the virus to the fetus. Pregnant women with weakened immune systems, such as those with HIV or undergoing immunosuppressive therapy, are at higher risk of severe illness. Symptoms in pregnant women, especially those with weakened immunity, can include fever, fatigue, shortness of breath, cough, vision problems, gastrointestinal symptoms, and encephalitis. Active maternal infection during pregnancy carries the risk of miscarriage or stillbirth in severe cases.
Diagnosis and Prevention
The diagnosis of CMV is made through a simple blood test or sample of other body fluids or tissue. Regular screening is recommended for pregnant women to detect CMV infection early. In cases of congenital CMV, doctors may perform an ultrasound and amniocentesis to check for any CMV-related abnormalities and test the baby at birth or within the first two weeks.
It's important to note that CMV is not related to food, water, or animals. Almost everyone encounters CMV by the age of 20.
| Group | Common Symptoms/Health Risks | Long-term Sequelae/Complications | |------------------|------------------------------------------------------|----------------------------------------------------| | Newborns (cCMV) | Rash, jaundice, microcephaly, enlarged liver/spleen, seizures, sensorineural hearing loss, vision impairment | Hearing loss, cerebral palsy, developmental delays, vision loss, seizures, death in severe cases[1][2][4] | | Pregnant Women | Often asymptomatic; possible fever, fatigue, respiratory symptoms; severe in immunocompromised | Risk of fetal infection, pregnancy loss, severe neonatal outcomes if fetus infected[2][3][4] |
[1] Centers for Disease Control and Prevention. (2021). Congenital Cytomegalovirus (CMV) in Infants. Retrieved from https://www.cdc.gov/cmv/clinical-issues/congenital.html [2] American Pregnancy Association. (2021). Cytomegalovirus (CMV). Retrieved from https://americanpregnancy.org/pregnancy-complications/cytomegalovirus/ [3] March of Dimes. (2021). Cytomegalovirus (CMV). Retrieved from https://www.marchofdimes.org/complications/cytomegalovirus-cmv.aspx [4] National Institute of Child Health and Human Development. (2021). Cytomegalovirus (CMV) Infection in Pregnancy Fact Sheet. Retrieved from https://www.nichd.nih.gov/health/topics/cmv/conditioninfo/Pages/default.aspx
