Volume 7, Issue 1, January 2019, Page: 25-30
Socio-biologic Predictors of Active Cytomegalovirus Infection Among Pregnant Women in a Low-resource Setting
Awoleke Jacob Olumuyiwa, Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Nigeria
Omoyajowo Adefunke Christianah, Department of Mathematics and Statistics, Bowen University, Osun State, Nigeria
Ajayi David Daisi, Department of Medical Laboratory Science, Ekiti State University Teaching Hospital, Ado – Ekiti, Nigeria
Awoleke Adeola Olabisi, School of Nursing, Ekiti State University Teaching Hospital, Ado – Ekiti, Nigeria
Received: Feb. 16, 2019;       Accepted: Mar. 22, 2019;       Published: Apr. 13, 2019
DOI: 10.11648/j.jgo.20190701.14      View  15      Downloads  3
Active maternal cytomegalovirus (CMV) infection is the bedrock of congenital CMV with its debilitating sequelae. Information on socio-biologic predictors of active maternal infection in southwest Nigeria is lacking. However, modifying locality-specific risk factors could reduce the burden of CMV. The aim of the study is to identify the socio-biologic determinants for active maternal CMV infection in a Nigerian setting. Using a cross-sectional design, ELISA kits were employed to quantify the anti-CMV IgG and IgM antibodies in the sera of consecutive antenatal attendees at the Ekiti State University Teaching Hospital (EKSUTH), Nigeria. Among the respondents, 23 (12.4%) were seropositive for both anti-CMV IgG and IgM antibodies. The regression analysis showed that the likelihood of being seropositive for both anti-CMV IgG and IgM antibodies was predicted by having a child less than 5 years old (adjusted OR: 5.53; 95% CI: 1.08 – 28.30; p = 0.04), while those who were skilled workers were least likely to be seropositive for both antibodies (adjusted OR: 0.06; 95% CI: 0.01 – 0.95; p = 0.04). Also, infection with cytomegalovirus was associated with pre-eclampsia (adjusted OR: 0.03; 95% CI: 0.002 – 0.41; p = 0.01). High prevalence of active maternal CMV infection was noted from the study, and this was associated with pre-eclampsia and caring for children under-5. Educating pregnant non-immune women about CMV and its prevention, coupled with the improvement in socio-economic status of the populace can reduce the burden in low-resource settings.
Cytomegalovirus, Socio-biologic Predictors, Immunoglobulin M (IgM), Screening, Low-resource Setting
To cite this article
Awoleke Jacob Olumuyiwa, Omoyajowo Adefunke Christianah, Ajayi David Daisi, Awoleke Adeola Olabisi, Socio-biologic Predictors of Active Cytomegalovirus Infection Among Pregnant Women in a Low-resource Setting, Journal of Gynecology and Obstetrics. Vol. 7, No. 1, 2019, pp. 25-30. doi: 10.11648/j.jgo.20190701.14
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This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
S. Bonalumi, A. Trapanese, A. Santamaria, L. D’Emidio, and L. Mobili (2011). Cytomegalovirus infection in pregnancy: review of the literature. Journal of Perinatal Medicine 5, 1–8.
J. G. Dobbins, J. A. Stewart, and G. J. Demmler (1992). Surveillance of congenital cytomegalovirus disease, 1990-1991. Collaborating Registry Group. MMWR CDC Surveill Summ 41, 35–39.
M. J. Korndewal, A. M. Oudesluys-Murphy, A. C. M. Kroes, A. C. T. Vossen, and H. E. de Melker (2017). Congenital Cytomegalovirus Infection: Child Development, Quality of Life and Impact on Daily Life. Pediatr Infect Dis J 36, 1141–1147.
A. Carlson, E. R. Norwitz, and R. J. Stiller (2010). Cytomegalovirus infection in pregnancy: Should all women be screened? Reviews in Obstetrics and Gynecology 3, 172–179.
S. B. Boppana, L. B. Rivera, K. B. Fowler, M. Mach, and W. J. Britt (2001). Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N Engl J Med 344, 1366–1371.
A. Y. Yamamoto, M. M. Mussi-Pinhata, S. B. Boppana, Z. Novak, V. M. Wagatsuma, P. F. Oliveira, et al (2010). Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population. Am J Obstet Gynecol 202, 297.e1–8.
R. F. Pass, and R. Arav-Boger (2018). Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention. F1000Research 7 (F1000 Faculty Rev), 255 (doi: 10.12688/f1000research.12517.1).
S. M. Price, E. Bonilla, P. Zador, D. M. Levis, C. L. Kilgo, and M. J. Cannon (2014). Educating women about congenital cytomegalovirus: assessment of health education materials through a web-based survey. BMC Women’s Health 14, 144. DOI: 10.1186/S12905-014-0144-3.
S. B. Boppana, R. F. Pass, W. J. Britt, S. Stagno, and C. A. Alford (1992). Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J 11, 93–99.
T. M. Lanzieri, S. C. Dollard, S. R. Bialek, and S. D. Grosse (2014). Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries. Int J Infect Dis 22, 44–48.
Z. Mainji, and A. K. Nyamache (2014). Seroprevalence of Cytomegalovirus (CMV) among pregnant women in Thika, Kenya. BMC Res Notes 7, 794.
A. Nawawy, A. T. Soliman, O. Azzouni, S. Amer, M. A. Karim, S. Demian, et al (1996). Maternal and neonatal prevalence of toxoplasma and cytomegalovirus (CMV) antibodies and hepatitis-B antigens in an Egyptian rural area. J Trop Pediatr 42, 154–157.
S. I. Khairi, K. S. Intisar, K. H. Enan, M. Y. Ishag, A. M. Baraa, and Y. H. Ali (2013). Seroprevalence of cytomegalovirus infection among pregnant women at Omdurman Maternity Hospital. Sudan J Med Lab Diagn 4, 45–49.
O. E. Ephraim, O. Oyinlola, V. L. Patrick, U. O. Joseph, and J. E. Charles (2013). Seroprevalence and risk factors for cytomegalovirus infection among pregnant women in southern Nigeria. JMID 3, 123–127.
C. Bello, and H. Whittle (1991). Cytomegalovirus infection in Gambian mothers and their babies. J Clin Pathol 44, 366–369.
K. B. Fowler, S. Stagno, R. F. Pass, W. J. Britt, T. J. Boll, and C. A. Alford (1992). The outcome of congenital cytomegalovirus infection in relation to maternal antibody status. N Engl J Med 326, 663–667.
C. Wang, X. Zhang, S. Bialek, and M. J. Cannon (2011). Attribution of congenital cytomegalovirus infection to primary versus non-primary maternal infections. Clin Infect Dis 52, e11–3.
M. M. Mussi-Pinhata, A. Y. Yamamoto, R. M. Moura-Brito, I. M. de Lima, de Carvalhoe P. F. Oliveira, S. Boppana, et al (2009). Birth prevalence and natural history of congenital cytomegalovirus infection in a highly sero-immune population. Clin Infect Dis 49, 522–528.
J. J. de Vries, E. W. van Zwet, F. W. Dekker, A. C. Kroes, P. H. Verkerk, and A. C. Vossen (2013). The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population-based prediction model. Rev Med Virol 23, 241–249.
S. P. Adler, J. W. Finney, A. M. Manganello, and A. M. Best (2004). Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J Pediatr 145, 485–491.
J. Harvey, and C. L. Dennis (2008). Hygiene interventions for prevention of cytomegalovirus infection among childbearing women: systematic review. J Adv Nurs 63, 440–450.
C. Vauloup-Fellous, O. Picone, A. G. Cordier, I. Parent-du-Chatelet, M. N. Senat, R. Frydman, and L. Grangeot-Keros (2009). Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French Hospital. J Clin Virol 46, suppl 4: S49–53.
R. F. Pass, and B. Anderson (2014). Mother-to-Child Transmission of Cytomegalovirus and Prevention of Congenital Infection. J Pediatric Infect Dis Soc 3, Suppl 1: S2–6.
W. D. Rawlinson, S. B. Boppana, K. B. Fowler, D. W. Kimberlin, T. Lazzarotto, S. Alain, et al (2017). Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis 17, e177–e188.
R. F. Pass, and C. Hutto (1986). Group day care and cytomegaloviral infections of mothers and children. Rev Infect Dis 8, 599–605.
M. J. Cannon, J. D. Stowell, R. Clark, P. R. Dollard, D. Johnson, K. Mask, et al (2014). Repeated measures study of weekly and daily cytomegalovirus shedding patterns in saliva and urine of healthy cytomegalovirus-seropositive children. BMC Infect Dis 14, 569.
S. A. S. Staras, S. C. Dollard, K. W. Radford, W. D. Flanders, R. F. Pass, and M. J. Cannon (2006). Seroprevalence of cytomegalovirus infection in the United States, 1988–1994. Clin Infect Dis 43, 1152–1153.
S. P. Adler (1989). Cytomegalovirus and child day care. Evidence for an increased infection rate among day-care workers. N Engl J Med 321, 1290–1296.
R. F. Pass, C. Hutto, M. D. Lyon, and G. Cloud (1990). Increased rate of cytomegalovirus infection among day care center workers. Pediatr Infect Dis J 9, 465–470.
S. P. Adler (1988). Cytomegalovirus transmission among children in day care, their mothers and caretakers. Pediatr Infect Dis J 7, 279–285.
R. F. Pass, C. Hutto, R. Ricks, and G. A. Cloud (1986). Increased rate of cytomegalovirus infection among parents of children attending day-care centers. N Engl J Med 314, 1414–1418.
S. P. Adler, J. W. Finney, A. M. Manganello, and A. M. Best (2004). Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J Pediatr 145, 485–491.
S. Stagno, R. F. Pass, G. Cloud, W. J. Britt, R. E. Henderson, P. D. Walton, et al (1986). Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus, and clinical outcome. JAMA 256, 1904–1908.
K. B. Fowler, S. Stagno, and R. F. Pass (2003). Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA 289, 1008–1011.
P. D. Griffiths, and C. Baboonian (1984). Intra-uterine transmission of cytomegalovirus in women known to be immune before conception. J Hyg 92, 89–95.
K. Schopfer, E. Lauber, and U. Krech (1978). Congenital cytomegalovirus infection in newborn infants of mothers infected before pregnancy. Arch Dis Child 53, 536–539.
P. von Dadelszen, and L. A. Magee (2002). Could an infectious trigger explain the differential maternal response to the shared placental pathology of pre-eclampsia and normotensive intrauterine growth restriction? Acta Obstet Gynecol Scand 81, 642–648.
D. G. Goulis, L. Chappell, R. G. Gibbs, D. Williams, J. R. Dave, P. Taylor, et al (2005). Association of raised titres of antibodies to Chlamydia pneumoniae with a history of pre-eclampsia. BJOG 112, 299–305.
J. O. Awoleke, G. O. Ajayi, and O. Adegbola (2012). Prevalence of Chlamydophila pneumoniae antibodies in women with pre-eclampsia in Lagos, Nigeria. West African Journal of Medicine 31, 253–258.
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