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Cytomegalovirus-Specific Hyperimmune Immunoglobulin Administration for Secondary Prevention after First-Trimester Maternal Primary Infection: A 13-Year Single-Center Cohort Study.
Karofylakis, Emmanouil; Thomas, Konstantinos; Kavatha, Dimitra; Galani, Lamprini; Tsiodras, Sotirios; Giamarellou, Helen; Papaevangelou, Vassiliki; Antoniadou, Anastasia.
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  • Karofylakis E; Fourth Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece.
  • Thomas K; Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
  • Kavatha D; Fourth Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece.
  • Galani L; Fourth Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece.
  • Tsiodras S; 1st Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, 4 Erythrou Stavrou & Kifisias, Marousi, 15123 Athens, Greece.
  • Giamarellou H; Fourth Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece.
  • Papaevangelou V; 1st Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, 4 Erythrou Stavrou & Kifisias, Marousi, 15123 Athens, Greece.
  • Antoniadou A; Third Department of Pediatrics, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Viruses ; 16(8)2024 Aug 02.
Article en En | MEDLINE | ID: mdl-39205215
ABSTRACT
Primary cytomegalovirus infection during pregnancy has a high risk of vertical transmission, with severe fetal sequelae mainly associated with first-trimester infections. We conducted a retrospective analysis of 200 IU/kg cytomegalovirus-specific hyperimmune globulin (HIG), used in first-trimester maternal primary infections for congenital infection prevention. The primary outcome was vertical transmission, defined as neonatal viruria or positive amniocentesis if pregnancy was discontinued. HIG, initially administered monthly and since 2019 biweekly, was discontinued in negative amniocentesis cases. Women declining amniocentesis and positive amniocentesis cases with normal sonography were offered monthly HIG until delivery as a treatment strategy. The total transmission rate was 29.9% (32/107; 10 pregnancy terminations with positive amniocentesis, 18 completed pregnancies with positive amniocentesis and 4 declining amniocentesis). Maternal viremia was the only factor associated with fetal transmission (OR 4.62, 95% CI 1.55-13.74). The transmission rate was not significantly different whether HIG was started during the first or second trimester (28.2% vs. 33.3%; p = 0.58), or between monthly and biweekly subgroups (25.7% vs. 37.8%, p = 0.193). Pre-treatment maternal viremia could inform decisions as a predictor of congenital infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Infecciosas del Embarazo / Primer Trimestre del Embarazo / Infecciones por Citomegalovirus / Transmisión Vertical de Enfermedad Infecciosa Límite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Revista: Viruses Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Infecciosas del Embarazo / Primer Trimestre del Embarazo / Infecciones por Citomegalovirus / Transmisión Vertical de Enfermedad Infecciosa Límite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Revista: Viruses Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Suiza