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Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review.

Publication ,  Journal Article
Coppola, T; Mangold, JF; Cantrell, S; Permar, SR
Published in: Vaccines (Basel)
September 26, 2019

Congenital cytomegalovirus (cCMV) is the leading non-genetic cause of sensorineural hearing loss (SNHL), and efforts are geared towards prevention through vaccine development. Transmission rates following primary maternal infection occur at rates of 30-40%, however reported placental rates upon non-primary maternal infection is reported to be less than <4%. There is significant debate about whether this reduction in transmission rate is due to pre-existing maternal immunity, which could identify possible immunologic targets for vaccines. To address this question, we performed a systemic review of the literature using Preferred Reporting Items for Systematic Review and Analysis (PRISMA) guidelines. We identified cohort studies in high CMV seroprevalent (>80%) areas or in developing regions that examined a cohort of at least 50 infants for congenital CMV acquisition. We identified 19 articles that met criteria and were further categorized based on pre-conception serology, maternal seroprevalence, or previously known seroprevalence. Birth prevalence rates ranged from 0.4% to 6% (median 1.1%), with the studies reporting on clinical outcome (16/19 studies) noting the majority of infected infants as asymptomatic. We also utilized a recent study that differentiated primary maternal infections from chronic infections in a highly seropositive population to calculate a placental transmission rate in women with pre-existing immunity compared to that of no pre-existing immunity. This work confirms a low cCMV birth prevalence in highly seropositive populations, indicates via a calculated placental transmission rate that the CMV placental transmission rate is lower in non-primary infection than that of primary infection, and reveals gaps in data for further research aiming to identify targets for vaccine development.

Duke Scholars

Published In

Vaccines (Basel)

DOI

ISSN

2076-393X

Publication Date

September 26, 2019

Volume

7

Issue

4

Location

Switzerland

Related Subject Headings

  • 3207 Medical microbiology
  • 3204 Immunology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Coppola, T., Mangold, J. F., Cantrell, S., & Permar, S. R. (2019). Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review. Vaccines (Basel), 7(4). https://doi.org/10.3390/vaccines7040129
Coppola, Tiziana, Jesse F. Mangold, Sarah Cantrell, and Sallie R. Permar. “Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review.Vaccines (Basel) 7, no. 4 (September 26, 2019). https://doi.org/10.3390/vaccines7040129.
Coppola T, Mangold JF, Cantrell S, Permar SR. Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review. Vaccines (Basel). 2019 Sep 26;7(4).
Coppola, Tiziana, et al. “Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review.Vaccines (Basel), vol. 7, no. 4, Sept. 2019. Pubmed, doi:10.3390/vaccines7040129.
Coppola T, Mangold JF, Cantrell S, Permar SR. Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review. Vaccines (Basel). 2019 Sep 26;7(4).

Published In

Vaccines (Basel)

DOI

ISSN

2076-393X

Publication Date

September 26, 2019

Volume

7

Issue

4

Location

Switzerland

Related Subject Headings

  • 3207 Medical microbiology
  • 3204 Immunology
  • 3202 Clinical sciences