A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology

Introduction. Cytomegalovirus (CMV) infection is the most common perinatal infection worldwide, diagnosed in 0.5-1.3 % of newborns in various regions. Approximately 86.0 % of women of childbearing age are seropositive for CMV. While a substantial body of research has focused on developing methods fo...

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Main Author: A. Zinchuk
Format: Article
Language:English
Published: Publishing House "Kyrylytsya" 2024-12-01
Series:Львівський клінічний вісник
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Online Access:https://lcb-journal.com/index.php/journal/article/view/340
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author A. Zinchuk
author_facet A. Zinchuk
author_sort A. Zinchuk
collection DOAJ
description Introduction. Cytomegalovirus (CMV) infection is the most common perinatal infection worldwide, diagnosed in 0.5-1.3 % of newborns in various regions. Approximately 86.0 % of women of childbearing age are seropositive for CMV. While a substantial body of research has focused on developing methods for the etiotropic treatment of pregnant women with primary CMV infection to prevent neonatal disease (secondary prevention) and evaluating the feasibility of screening pregnant women for CMV, these aspects remain unclear and require further investigation. The aim of the study. The aim of this study is to examine the latest scientific findings regarding the transplacental transmission of CMV infection, methods of secondary prevention, and the feasibility of screening pregnant women to reduce the risk of neonatal pathology. Materials and methods. An analysis of published scientific works was conducted by searching for relevant articles in the PubMed database, as well as reviewing clinical guidelines from professional organizations. These sources address the treatment of CMV infection in pregnant women for secondary prevention of neonatal disease and the feasibility of screening pregnant women for CMV infection. A total of 35 sources of scientific literature were selected for further analysis. Results and discussion. The feasibility of serological screening for CMV infection in pregnant women, aimed at reducing the risk of neonatal disease, continues to be debated in the scientific literature. With the emergence of new data regarding the effectiveness of prophylactic antiviral treatment of primary CMV infection in pregnant women with valacyclovir, the question of CMV screening is being gradually reconsidered throughout 2024. The European Congenital Infections Initiative of the European Society of Clinical Virology now recommends universal serological screening for CMV in all pregnant women as early as possible in the first trimester, with repeat testing every 4 weeks until 14–16 weeks of pregnancy for seronegative women identified at initial screening. Conclusion. Given the new scientific evidence regarding the effectiveness of prophylactic antiviral treatment for primary CMV infection in pregnant women with valacyclovir, as well as the evolving question of CMV screening in early pregnancy, we believe these issues warrant further in-depth study and reevaluation by Ukrainian specialists. It is essential to address the question of whether updates to the "Standards of Medical Care for Normal Pregnancy" are warranted. The issue of CMV infection, like perinatal infections in general, is complex and requires the involvement of a multidisciplinary group of experts, including infectious disease specialists and pediatric infectious disease experts.
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spelling doaj-art-9e8ae259a4274d1b976f98c8a02e06b92025-08-20T02:18:32ZengPublishing House "Kyrylytsya"Львівський клінічний вісник2306-42692520-28982024-12-014 (48)343910.25040/lkv2024.04.034340A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal PathologyA. Zinchuk0Danylo Halytsky Lviv National Medical University, Lviv, UkraineIntroduction. Cytomegalovirus (CMV) infection is the most common perinatal infection worldwide, diagnosed in 0.5-1.3 % of newborns in various regions. Approximately 86.0 % of women of childbearing age are seropositive for CMV. While a substantial body of research has focused on developing methods for the etiotropic treatment of pregnant women with primary CMV infection to prevent neonatal disease (secondary prevention) and evaluating the feasibility of screening pregnant women for CMV, these aspects remain unclear and require further investigation. The aim of the study. The aim of this study is to examine the latest scientific findings regarding the transplacental transmission of CMV infection, methods of secondary prevention, and the feasibility of screening pregnant women to reduce the risk of neonatal pathology. Materials and methods. An analysis of published scientific works was conducted by searching for relevant articles in the PubMed database, as well as reviewing clinical guidelines from professional organizations. These sources address the treatment of CMV infection in pregnant women for secondary prevention of neonatal disease and the feasibility of screening pregnant women for CMV infection. A total of 35 sources of scientific literature were selected for further analysis. Results and discussion. The feasibility of serological screening for CMV infection in pregnant women, aimed at reducing the risk of neonatal disease, continues to be debated in the scientific literature. With the emergence of new data regarding the effectiveness of prophylactic antiviral treatment of primary CMV infection in pregnant women with valacyclovir, the question of CMV screening is being gradually reconsidered throughout 2024. The European Congenital Infections Initiative of the European Society of Clinical Virology now recommends universal serological screening for CMV in all pregnant women as early as possible in the first trimester, with repeat testing every 4 weeks until 14–16 weeks of pregnancy for seronegative women identified at initial screening. Conclusion. Given the new scientific evidence regarding the effectiveness of prophylactic antiviral treatment for primary CMV infection in pregnant women with valacyclovir, as well as the evolving question of CMV screening in early pregnancy, we believe these issues warrant further in-depth study and reevaluation by Ukrainian specialists. It is essential to address the question of whether updates to the "Standards of Medical Care for Normal Pregnancy" are warranted. The issue of CMV infection, like perinatal infections in general, is complex and requires the involvement of a multidisciplinary group of experts, including infectious disease specialists and pediatric infectious disease experts.https://lcb-journal.com/index.php/journal/article/view/340cytomegalovirus infection, screening, pregnant women, newborns, congenital malformations
spellingShingle A. Zinchuk
A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
Львівський клінічний вісник
cytomegalovirus infection, screening, pregnant women, newborns, congenital malformations
title A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
title_full A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
title_fullStr A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
title_full_unstemmed A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
title_short A View of the Problem of Cytomegalovirus Infection in Pregnant Women: Secondary Prevention with Valacyclovir and the Feasibility of Universal Serological Screening to Reduce the Risk of Neonatal Pathology
title_sort view of the problem of cytomegalovirus infection in pregnant women secondary prevention with valacyclovir and the feasibility of universal serological screening to reduce the risk of neonatal pathology
topic cytomegalovirus infection, screening, pregnant women, newborns, congenital malformations
url https://lcb-journal.com/index.php/journal/article/view/340
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