432 - Cytomegalovirus shedding in seropositive pregnant women

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 432
Publication Number: 432.419

Shannon Ross, University of Alabama School of Medicine, Birmingham, AL, United States; Suresh B. Boppana, University of Alabama School of Medicine, Birmingham, AL, United States; Karen B. Fowler, University of Alabama School of Medicine, Birmingham, AL, United States; Anslee L. Vinson, University of Alabama at Birmingham School of Medicine, Sylacauga, AL, United States

Presenting Author(s)

SR

Shannon Ross, MD, MSPH

Professor of Pediatrics
University of Alabama School of Medicine
Birmingham, Alabama, United States

Background:

Congenital CMV is a common cause of hearing loss and other sequelae in children. Rates of congenital CMV are higher in maternal populations seropositive prior to pregnancy. Data on CMV shedding patterns in seropositive pregnant women is limited and has shown varying rates among populations.

Objective:

This study aimed to characterize CMV shedding patterns in saliva, urine, vaginal secretions, and blood at different stages of pregnancy in an urban cohort.

Design/Methods:

Pregnant women positive for CMV IgG were enrolled after their first prenatal visit but before 20 weeks gestation and followed prospectively. Maternal demographics were obtained, and urine, saliva, vaginal, and blood samples were obtained at enrollment and regular intervals during pregnancy and immediately post-partum. Specimens were tested for CMV DNA by Real-time PCR.

Results: Among 193 pregnant women, 61% enrolled in the first trimester of pregnancy. The mean maternal age was 25.7 years, with the majority of women were Black , single, and with public/no insurance. Overall, 37.3 % (72/193, 95% CI 30.5-44.5%) of women shed CMV at least once in saliva, urine, vaginal secretions, and/or blood during the study. At the time of study enrollment, CMV DNA was found in saliva ( 2.8% [5/176]; 95% CI 0.9-6.5%), urine (5.2% [9/173]; 95% CI 2.4-10.0% ), and vaginal secretions (7.6% [13/171]; 95% CI 4.1-12.7%) . Blood was CMV positive in 3/173 women (1.7%; 95% CI 0.4-5.0% ). CMV DNA was detected only once in 20.2% (95% CI 14.6-26.9%) of women and 7.9% (95% CI 4.4-12.8%) women shed virus intermittently. CMV shedding was highest at 16 week visits in vaginal samples (17% [11/64], 95% CI 8.9-28.7%) and lowest in the blood at the enrollment visit (1.7% [3/173], 95% CI 0.4-5.0%).

Conclusion(s):

CMV shedding in seropositive women from an urban, predominately Black cohort is common during pregnancy. Further study is needed on whether CMV shedding in seroimmune pregnant women is related to new CMV exposures during pregnancy, and whether shedding in seropositive pregnant women results in a higher risk of having an infant with congenital CMV.