Abstract Details

<< Back to Schedule

9/26/2014  |   10:45 AM - 11:15 AM   |  Topical Session 2   |  Wyoming

Pregnancy outcomes in non-primary and primary Cytomegalovirus maternal infections

BACKGROUND: Cytomegalovirus (CMV) is the most common cause of intrauterine infection. Unlike other infections, preconceptional immunity against CMV provides only a partial protection and intrauterine transmission of CMV has been reported in 0.5% to 2.2% of cases. Although, it is generally accepted that symptomatic congenital infections are rare, in recent years there is an increasing evidence that-non primary maternal infection may be a significant cause of severe congenital disease. OBJECTIVE: To evaluate the pregnancy outcomes (maternal-fetal rate of transmission and incidence of symptomatic congenital disease) of non-primary maternal infections versus primary infections. STUDY DESIGN: Retrospective study of pregnant women with active CMV infection, referred to our units in a 13 years period (1999-2011). Patients were divided into 2 groups according to the results of confirmatory serologic testing (avidity test, immunoblotting): serologic profile consistent with non-primary infection and serologic profile suggestive of primary infection. We compared the vertical transmission rate, the sensibility and specificity of amniocentesis and the percentage of symptomatic infections into the two groups. RESULTS: Long term follow-up was available in 1099 cases: 188 non-primary infections and 911 primary maternal infections. Congenital infections were diagnosed in 9 (4.79%) fetuses/neonates of non-primary infection group and in 218 (23.92%) fetuses/neonates of primary infection group (p<.001). 553 amniocentesis were performed in primary infection group with a sensibility of 70.5% and specificity of 99.5%. In non-primary infection group 14 amniocentesis were performed, with a 100% of sensibility and specificity. Numbers of symptomatic infected fetuses/neonates were not statistically different into the two groups: 2 (22.2%) in non-primary infections versus 48 (22.0%) in primary infections (p= n.s.). CONCLUSION: Although pre-existing maternal immunity significantly reduces maternal-fetal transmission, the rate of symptomatic congenital CMV disease is similar in both infection groups. Amniocentesis could be useful to identify infected and non infected fetuses/newborns in both cases.

Brunella Guerra (Author), brunella.guerra@unibo.it;
MD, Specialist in Obstetrics and Gynecology. Department of Obstetrics and Gynecology, Obstetrics and Prenatal Medicine Unit, University of Bologna. 2008: Head of clinic for infectious diseases in pregnancy, S.Orsola-Malpighi General Hospital, Bologna, Italy. 1985: Stage of Prenatal Medicine at the Mount Sinai Medical Center (Mount Sinai Hospital and Mount Sinai School of Medicine) New York, NY. Professor of Gynecology and Obstetrics. Author of 363 scientific papers (95 on international scientific journals, IF 339,416 ) Research areas: Vertical transmission of maternal infections, Prenatal diagnosis of congenital CMV infection, Identification of maternal and foetal prognostic markers in utero CMV transmission, National survey of antiretroviral treatment in HIV infected pregnant women. Member of scientific committee of the Italian Society for Cervical Pathology and Colposcopy since 2007. Member of scientific committee of Genital Pathology School, IRCCS- Oncologic Institute, Milan, Italy, since 2008

Giuliana Simonazzi (Co-Presenter,Author), giuliana.simonazzi@unibo.it;
Giuliana Simonazzi is a Researcher in Gynaecology and Obstetrics at the University of Bologna and works assistant medical director at the Prenatal Medicine and Obstetrics Unit of S.Orsola Malpighi University Hospital, Bologna. She subsequently specialized in Gynaecology and Obstetrics at the same University and was awarded her specialization degree in 2004. She held a six-month post as research fellow at the Maternal - Fetal Medicine Division, Thomas Jefferson University di Philadelphia (PA, USA) from 2003 to 2004. In 2008 she was awarded a research doctorate in Mother, Infant and Child Medicine by the University of Bologna. Dr. Simonazzi's main field of interest is obstetric disease, focusing on the prenatal diagnosis and treatment of morphological and auxological abnormalities of foetal development. She has authored more than 40 scientific publications cited by the Journal Citation Report. She is an executive member of the Italian Society of Obstetric and Gynaecological Ultrasound (SIEOG).

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Tiziana Lazzarotto (Author), tiziana.lazzarotto@unibo.it;
She graduated with a degree in Biological Science from the University of Bologna (Italy) and received her scientific training for her specialty degree in Microbiology and Virology at the University of Bologna (Italy). She is Associate Professor of Microbiology and Clinical Microbiology, Department of Specialised, Experimental and Diagnostic Medicine, School of Medicine at Alma Mater Studiorum University of Bologna (Italy). Head of the Laboratory of Virology at the Clinical Operative of Microbiology at St. Orsola Malpighi University General Hospital, Bologna (Italy). Since her thesis she has published more than 168 scientific papers (121 on international-selected Current Contents, and 47 on national and international journals). In particular she has made significant contributions in the diagnosis and prognosis of congenital cytomegalovirus infection. Visiting Professor in 2000 at the Department of Paediatrics, University of Alabama, Birmingham, USA.

Chiara Puccetti (Author), puccetti.chiara@gmail.com;
Education and Training : 1999: Degree at Scientific High School “Ricci Curbastro” in Lugo (RA), with 86/100 votations. 2005: Graduation in Medicine and Surgery at University of Bologna, with 110/110 cum laude votations 2010: Specialization Diploma in Obstetrics and Gynecology at the University of Bologna, with 70/70 cum laude votations From 2012: PhD student in “Scienze mediche generali e dei servizi”. Work Experience: Research activity focused on Infectious diseases in pregnancy and prenatal diagnosis. She has authored about 30 scientific publications cited by the Journal Citation Report

Mariagrazia Capretti (Author), mariagrazia.capretti@aosp.bo.it;
Mariagrazia Capretti in an assistant medical director at the Pediatric Unit of S.Orsola Malpighi University Hospital, Bologna. She subsequently specialized in Pediatrics at the same University. In 2008 she was awarded a research doctorate in Mother, Infant and Child Medicine by the University of Bologna. Dr. Capretti's main fields of interest are nosocomial neonatal infections, neonatal sepsis and congenital/perinatal infections(toxoplasmosis, siphylis, CMV, HIV, HCV). She has authored more than 20 scientific publications cited by the Journal Citation Report.

Valentina Daveri (Author), valed8@msn.com;
Degree in Medicine and Surgery in march 2014 at Alma Mater Studiorum University of Bologna, Italy. Practising Doctor in Gynaecology and Obstetrics at the Prenatal Medicine and Obstetrics Unit of S.Orsola Malpighi University Hospital, Bologna, actually involved in research and management of infectious diseases in pregnancy and Mother-to-child transmission.

Margherita Contoli (Author), margherita.contoli@gmail.com;
Margherita Contoli, MD, Medical degree at the University of Bologna on March 20th, 2014. Intern doctor since 2009 at U.O. Clinica Ostetrica e Medicina dell'Età Prenatale. Main field of interest is obstetric desease, focusing on the prenatal diagnosis and treatment of infectious diseases in pregnancy.

Francesca Cervi (Author), cervi.fra@gmail.com;
She graduated in Medicine and Surgery at University of Bologna, with 110/110 cum laude votations. She is receiving her scientific training for her specialty degree in Gynaecology and Obstetrics at the University of Bologna (Italy). Dr. Cervi's main field of interest is obstetric diseaseS, focusing on the prenatal diagnosis and maternal-fetal infectous

Liliana Gabrielli (Author), liliana.gabrielli@aosp.bo.it;
She graduated with a degree in Medicine and Surgery from the University of Bologna (Italy). She is Medical Doctor, Specialist in Microbiology and Virology, Consultant at University Hospital of Bologna, St. Orsola Malpighi General Hospital. She works at the Clinical Operative of Microbiology, Laboratory of Virology. Since her thesis she has published more than 50 scientific papers (31 on international-selected Current Contents and 19 on national and international journals). Visiting Professor in 2000 at the Department of Medical Virology, University Hospital of Tubingen, Germany and the Department of Virology, University of Ulm, Germany to investigate some aspects of the mechanism of pathogenesis of congenital cytomegalovirus infection. Degree Honors and Awards: “AMCLI”, Italian Society for Clinical Microbiology (2000 and 2007) and “Eva contro Eva – tra biologia e società”, Italian Society of Gynaecology and Obstetrics (SIGO) (2005).

Sara Zagonari (Author), sara.zagonari@aosp.bo.it;
Sara Zagonari graduated with a degree in Medicine and Surgery from the University of Bologna (Italy). She specialized in Gynaecology and Obstetrics at the same University and she actually works as assistant medical director at the Prenatal Medicine and Obstetrics Unit of S.Orsola Malpighi University Hospital, Bologna. Research activity focused on Infectious diseases in pregnancy and prenatal diagnosis.

Presentation:
This presentation has not yet been uploaded.

Handouts:
No handouts have been uploaded.