Njue A, Margulis AV, Lyall M, Nuabor W, Marks M, Russell K, Sinha A. Congenital cytomegalovirus: what are the rates of maternal screening, diagnostic amniocentesis, and elective termination? Poster presented at the ID Week 2019; October 4, 2019. Washington, DC.

Background: Congenitally transmitted cytomegalovirus (CMV) is the leading infectious cause of deafness and intellectual impairment among infants. Due to lack of effective preventive and curative treatments, routine CMV screening of pregnant women is generally not recommended by clinical guidelines or public health authorities, but is conducted on an opportunistic basis by specific health care systems and providers. This targeted review describes the rate of reported maternal screening for CMV infection and subsequent pregnancy outcomes.

Methods: PubMed and Embase were searched to identify English-language articles reporting the rate of screening for CMV maternal infection (Objective 1), the acceptance rate for diagnostic amniocentesis (Objective 2), and the elective termination rates due to CMV infection (Objective 3) in Europe and Israel. No date limit was applied.

Results: Seventeen articles published between 2000 and 2018 were included. Routine CMV screening of pregnant women in the absence of country-level guidelines appears to be common in France and Israel (Table). Conversely, in Portugal, where country-level guidelines exist for preconception screening, a high proportion of women are not screened (Table). Acceptance rates of diagnostic amniocentesis among women with CMV infection vary considerably across countries, with the highest rates reported in Israel (73%) and the lowest in Italy (16%). Elective termination rates were higher among women who underwent amniocentesis versus those who did not and those with primary CMV infection versus those with nonprimary infection. Conversely, one study in Israel showed higher termination rates among patients who did not undergo amniocentesis versus those who did (35.5% vs. 7.3%).

Conclusion: The available data indicate that routine screening is carried out in some countries to a variable degree. There is an unmet need for effective prevention and management options to help prevent unnecessary termination of pregnancy.

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