The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population‐based prediction model

Author:

de Vries Jutte J. C.1,van Zwet Erik W.2,Dekker Friedo W.3,Kroes Aloys C. M.1,Verkerk Paul H.4,Vossen Ann C. T. M.1

Affiliation:

1. Department of Medical Microbiology Leiden University Medical Center Leiden The Netherlands

2. Mathematical Institute Leiden University Medical Center Leiden The Netherlands

3. Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands

4. TNO Child Health Leiden The Netherlands

Abstract

SUMMARYBecause maternal seropositivity for CMV is associated with substantial protection against congenital CMV infection, prevention measures have focused mainly on seronegative pregnant women for decades. However, population‐wide insight in the contribution of nonprimary infection (reactivation and/or re‐infection with a different strain) on the most common sequela, hearing loss, is missing.A population‐based prediction model was developed to estimate the proportion of congenital CMV‐related hearing loss resulting from nonprimary maternal infection. Incorporated was a meta‐analysis of the risk of hearing loss, calculating pooled proportions of children with hearing loss after nonprimary and primary infection. Subsequently, the model was applied for worldwide present population seroprevalences (range 30–95%).It was estimated that, for all population seroprevalences, nonprimary maternal infections are responsible for the majority of congenital CMV infections. This proportion increased with seroprevalence, ranging from 57% (95%CI 24–85%) to 96% (95% CI 88–99%) for seroprevalences of 30% to 95%. Our meta‐analysis (six reports) showed that the risk of hearing loss after nonprimary infection was 11% (28/253 children, 95% CI 7–15%) versus 13% (50/385 children, 95% CI 10–16%) after primary infection. Incorporating this risk into our model, we estimated that nonprimary infections also accounted for the majority of CMV‐related hearing loss. This proportion ranged from 53% (95% CI 13–86%) to 95% (95% CI 62–99%) for seroprevalences of 30% to 95%.Our data underline the worldwide contribution of nonprimary infections in causing CMV‐related hearing loss. These results imply that prevention research such as vaccine and hygiene studies should not only be directed at seronegative but also seropositive pregnant women. Copyright © 2013 John Wiley & Sons, Ltd.

Publisher

Wiley

Cited by 169 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.7亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2025 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3