How does cytomegalovirus infection impact pregnancy?

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Cytomegalovirus (CMV) is a member of the herpes virus family and typically causes asymptomatic infections that remain latent primarily in bone marrow-derived cells. CMV is also responsible for congenital diseases among newborns and is classified as one of the TORCH infections (toxoplasmosis, other infections including syphilis, rubella, CMV, and herpes simplex virus) in pregnant women.

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1. Negative CMV infection: Your IgM test result is negative. A negative cytomegalovirus (CMV) IgM result suggests that you may not be experiencing an acute or active infection. However, a negative result does not rule out primary CMV infection. It has been reported that CMV-specific IgM antibodies were not detectable in up to 23 percent of pregnant women with primary CMV infection within eight weeks post-infection.
2. Positive IgG infection: Positive CMV IgG (immunoglobulin G) results indicate past or recent CMV infection. You may likely be transmitting CMV to susceptible individuals, including the fetus, through blood and tissue products.

If the above results indicate a positive maternal infection. However, the extent of fetal disease can be diagnosed by amniocentesis with or without viral load measurement at this time under the supervision and consultation of a gynecologist. If confirmed positive, there are various ways to manage the situation under the guidance of a gynecologist.

If you as parents decide to continue the pregnancy, close follow-up with regular ultrasound exams is essential. The use of CMV hyperimmune globulin (CMV HIG) as a preventive measure could reduce congenital infection in your newborn. Please consult your gynecologist regarding this specific solution. At birth, your newborn must be tested within three weeks via saliva or urine polymerase chain reaction (PCR) or culture. If the diagnosis is confirmed, close follow-up is crucial for symptoms.

If your newborn is asymptomatic, you will still need to continue follow-ups, particularly regular hearing screenings. In such cases, various pediatric subspecialists should be consulted, including audiologists, otolaryngologists, ophthalmologists, neurologists, development or behavior specialists, infectious disease specialists, and physical or occupational therapists.

If the newborn is infected and symptomatic, they should receive antiviral medication, such as oral Valganciclovir for six months, under the supervision of a pediatrician. This therapy has been shown to preserve normal hearing or prevent the progression of hearing loss, correlating with improved long-term neurodevelopmental outcomes. Close follow-up for both asymptomatic and symptomatic newborns is essential to monitor for the development of long-term complications.

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