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9/09/2025  |   11:00 AM - 11:30 AM   |  Breakout 4   |  Memorial Hall

Cytomegalovirus reinfections in seropositive pregnant women

Abstract Summary

Background Congenital Cytomegalovirus (CMV) is a common cause of hearing loss and other sequelae in children. Rates of congenital CMV are higher in maternal populations seropositive before pregnancy, possibly due to the acquisition of a new strain of CMV. This study aims to identify the rate of CMV reinfection during pregnancy and the risk factors for CMV reinfection. Methods Pregnant women positive for CMV IgG were enrolled after their first prenatal visit but before 20 weeks gestation and followed prospectively. Maternal demographics, possible risk factors, and blood were obtained at enrollment, 6 and 12-weeks post-enrollment, and delivery. Maternal sera were analyzed for strain-specific anti-CMV antibody reactivity to four CMV epitopes, and the appearance of a new strain-specific antibody reactivity during pregnancy was considered evidence of reinfection. Results The mean age at enrollment among 240 pregnant women was 27.3 years (±5.7). Women in the cohort were 76.9% non-Hispanic Black, 73.8% never married, and 79.2% lived in households with three or more people. At study enrollment, 53 women (22.1%) had antibody reactivity to all four CMV strains. Among the other 187 pregnant women, CMV reinfection was identified in 31 (16.6%) women. Those with reinfections all lived with young children, and 93.5% provided direct care of young children. Of the women without serological evidence of reinfections, 92.9% lived with young children, and 85.3% provided direct care of young children. Women with and without reinfection did not differ by age, socioeconomic status, marital status, or race/ethnicity. Conclusions In this urban cohort, CMV reinfections occur in 1 in 6 seropositive pregnant women. However, the number of reinfections was underestimated due to the limitations of the serological assay. All women with reinfections lived in households with young children, and over 90% had close contact with young children during their pregnancies.

Learning Objectives

• Define the frequency of reinfections in CMV seropositive pregnant women.
• Identify risk factors for CMV reinfections in pregnancy.
• Define the limitations of identifying CMV reinfections in pregnancy.

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