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JAMA. 2003 Feb 26;289(8):1008-11.

Maternal immunity and prevention of congenital cytomegalovirus infection.

Author information

  • 1Department of Pediatrics, University of Alabama, Birmingham, USA. kfowler@uab.edu

Abstract

CONTEXT:

Vaccine development to prevent congenital cytomegalovirus (CMV) infection has been impeded by the uncertainty over whether maternal immunity protects the fetus.

OBJECTIVE:

To determine whether the presence of maternal antibodies to CMV significantly reduces the risk of congenital CMV infection in future pregnancies.

DESIGN, SETTING, AND PARTICIPANTS:

Cohort study of 3461 multiparous women from a population with a high rate of congenital CMV infection who delivered newborns screened for congenital CMV infection between 1993 and 1998, and whose cord serum specimen from a previous delivery could be retrieved and tested for antibody to CMV.

MAIN OUTCOME MEASURE:

Congenital CMV infection according to maternal immune status, age, race, parity, and socioeconomic status.

RESULTS:

Of 604 newborns born to initially seronegative mothers, congenital CMV infection occurred in 18 (3.0%). In contrast, of 2857 newborns born to immune mothers, congenital CMV infection occurred in 29 (1.0%) Two factors, preconception maternal immunity (adjusted risk ratio, 0.31; 95% confidence interval, 0.17-0.58) and maternal age of 25 years or older (adjusted risk ratio, 0.19; 95% confidence interval, 0.07-0.49), were highly protective against congenital CMV infection. No other factors were associated with a reduction in the risk of congenital CMV infection.

CONCLUSION:

Naturally acquired immunity results in a 69% reduction in the risk of congenital CMV infection in future pregnancies.

Comment in

PMID:
12597753
[PubMed - indexed for MEDLINE]
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