1140. Awareness of Cytomegalovirus (CMV) Among Postpartum Mothers: Education Needed!

Abstract Background Congenital cytomegalovirus (cCMV) infection is the leading cause of non-genetic sensorineural hearing loss and affects approximately 0.5%-1% of all live births in the United States. Despite its substantial burden, maternal awareness of congenital CMV disease is limited. In addition, there is no information on CMV awareness among postpartum women who ultimately would consent for CMV newborn screening. Thus our objective of this study was to determine the proportion and characteristics of postpartum women who had knowledge of CMV in an academic medical center in Columbus, OH. Methods From May - December 2019, 276 postpartum women who delivered a newborn at the Ohio State University Wexner Medical Center, Columbus, OH were asked if they had prior knowledge of CMV. Eligible mothers had delivered an infant who was admitted to the Newborn Nursery, were ≥ 35 weeks’ gestational age, and had no signs of congenital CMV infection. These mothers had consented for enrollment of their newborn into the University of Alabama’s Collaborative Antiviral Study Group multicenter study on CMV screening (saliva) of asymptomatic infants. Pertinent demographic and clinical data were collected and subsequently managed using REDCap electronic data capture tools hosted at Nationwide Children’s Hospital, Columbus, OH. Statistical analyses were performed using GraphPad Prism. Results 505 eligible infants were born during the study period and 276 (55%) of the mothers were asked about their awareness of CMV infection. Of the 276 mothers (62%, white; 24%, Black; 3%, Asian; 0.4%, Native Hawaiian or Pacific Islander; 3%, biracial; 8%, not known), 30 (10%) had prior knowledge of CMV. Mothers who were aware of CMV did not differ from mothers who did not know about CMV in primigravida status (12/30 [40%] vs. 84/246 [34%], P=.55) or age (median, IQR; 33 years [29-35] vs. 31 years [26-34], P=.11). All infants had a normal physical examination, and none had congenital CMV infection. Conclusion Among postpartum mothers who consented to saliva screening of their newborns for congenital CMV infection, only 10% were previously aware of CMV. Such a knowledge gap should be addressed to better inform both universal and targeted newborn CMV screening among postpartum mothers. Disclosures All Authors: No reported disclosures

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Progressive Hearing Loss in Infants With Asymptomatic Congenital Cytomegalovirus Infection

PEDIATRICS ◽

10.1542/peds.90.6.862 ◽

1992 ◽

Vol 90 (6) ◽

pp. 862-866 ◽

Cited By ~ 1

Author(s):

W. Daniel Williamson ◽

Gail J. Demmler ◽

Alan K. Percy ◽

Francis I. Catlin

Keyword(s):

Hearing Loss ◽

Public Health Problem ◽

The United States ◽

Major Public Health Problem ◽

Cmv Infection ◽

Congenital Cytomegalovirus ◽

Computed Tomographic ◽

Significant Difference ◽

Congenital Cmv Infection ◽

Congenital Cmv

Congenital cytomegalovirus (CMV) infection is a major public health problem because 30 000 to 40 000 neonates with the infection are born each year in the United States. Although 90% of the congenitally infected infants are asymptomatic at birth, evidence is accumulating that these infants are at risk for audiologic, neurologic, and developmental sequelae. The current study describes the audiologic outcome of 59 infants with asymptomatic congenital CMV infection compared with 26 control infants. Eight of 59 infected infants had congenital sensorineural hearing loss (SNHL) but none of the control subjects did. Longitudinal audiologic assessments revealed that 5 of the 8 infants had further deterioration of their SNHL; a ninth infant with initially normal hearing experienced a unilateral SNHL during the first year of life, with further deterioration subseguently. The frequency of SNHL was similar for infected infants born to mothers with recurrent CMV infections during pregnancy (2 of 9) and for those born to mothers who experienced primary CMV infections (5 of 26). There was a significant difference between the occurrence of hearing loss in infected infants with normal computed tomographic scans (2 of 40) compared with those with either periventricular radiolucencies (4 of 13) or calcifications (1 of 3). Children with SNHL often have no identified cause of the loss; thus, it is likely that many of these children had asymptomatic congenital CMV infection. Given the progressive nature of SNHL associated with asymptomatic congenital CMV infection, longitudinal audiologic assessments are mandatory.

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The Association Between Maternal Cytomegalovirus Urinary Excretion and Congenital Infection Rate

10.21203/rs.3.rs-143971/v1 ◽

2021 ◽

Author(s):

Rita Zlatkin ◽

Efraim Bilavsky ◽

Joseph Pardo ◽

Lina Salman ◽

Ron Bardin ◽

...

Keyword(s):

Urinary Excretion ◽

Infection Rate ◽

Medical Center ◽

Congenital Infection ◽

Disease Rate ◽

Cmv Infection ◽

Non Invasive ◽

Disease Rates ◽

Congenital Cmv Infection ◽

Congenital Cmv

Abstract Background: Cytomegalovirus (CMV) vertical transmission occurs predominantly during primary maternal infection. There are no known non-invasive methods for diagnosis of fetal infection before delivery, however some risk factors have been suggested. We aimed to evaluate the association between maternal CMV urinary excretion and congenital CMV infection.Methods: A retrospective cohort study of all women who were diagnosed with primary CMV infection during pregnancy in a single university affiliated tertiary medical center, between 2012 and 2016. We examined congenital CMV infection and disease rates in women with and without CMV urinary excretion.Results: Overall, 126 women were included. There was no difference in maternal symptoms between the groups. We found no difference in congenital CMV infection and disease rates between women with and without urinary excretion of CMV (congenital infection rate 37.1% vs. 24.4%, p=0.209, congenital disease rate of 18.2% vs. 22.4%, p=0.648). Women with positive urinary CMV excretion had lower IgG avidity (36.7% vs 54.6%, p=0.007), with no additional difference in serology pattern. Compared to asymptomatic women, those with CMV related symptoms did not have significantly higher rates of urinary excretion of CMV (70% vs. 60.5%, p=0.38) or congenital infection rates (40.7% vs. 31.2%, p=0.48)Conclusion: Among women with primary CMV infection in pregnancy, we did not find an association between urinary excretion of CMV and congenital CMV infection.

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The association between maternal cytomegalovirus urinary excretion and congenital infection rate

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04194-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rita Zlatkin ◽

Efraim Bilavsky ◽

Joseph Pardo ◽

Lina Salman ◽

Ron Bardin ◽

...

Keyword(s):

Urinary Excretion ◽

Infection Rate ◽

Medical Center ◽

Congenital Infection ◽

Disease Rate ◽

Cmv Infection ◽

Non Invasive ◽

Disease Rates ◽

Congenital Cmv Infection ◽

Congenital Cmv

Abstract Background In utero Cytomegalovirus (CMV) vertical transmission occurs predominantly during primary maternal infection. There are no known non-invasive methods for diagnosis of fetal infection before delivery, however some risk factors have been suggested. We aimed to evaluate the association between maternal CMV urinary excretion and congenital CMV infection. Methods A retrospective cohort study of all women who were diagnosed with primary CMV infection during pregnancy in a single university affiliated tertiary medical center, between 2012 and 2016. We examined congenital CMV infection and disease rates among infants born to women with and without CMV urinary excretion. Results Overall, 126 women were included, 77 in the positive urinary excretion group, and 49 in the negative urinary excretion group. There was no difference in maternal symptoms between the groups. We found no difference in congenital CMV infection and disease rates between infants born to women with and without urinary excretion of CMV (congenital infection rate 37.1% vs. 24.4%, p = 0.209, congenital disease rate of 18.2% vs. 22.4%, p = 0.648). Women with positive urinary CMV excretion had lower IgG avidity values (36.7% vs 54.6%, p = 0.007), with no additional difference in serology pattern. Compared to asymptomatic women, those with CMV related symptoms did not have significantly higher rates of urinary excretion of CMV (70% vs. 60.5%, p = 0.38) or congenital infection rates (40.7% vs. 31.2%, p = 0.48). Conclusion Among infants of women with primary CMV infection in pregnancy, we did not find an association between urinary excretion of CMV and congenital CMV infection.

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Analytical and Clinical Performance of a Real-time Screening PCR Assay Identifying Congenital CMV Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.861 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S356-S356

Author(s):

Benjamin Rohde ◽

Maria Carillo-Marquez ◽

Ryan Tomlinson ◽

Jacqueline Blanch ◽

Young-In Kim-Hoehamer ◽

...

Keyword(s):

Real Time ◽

Screening Program ◽

Clinical Performance ◽

Low Cost ◽

The United States ◽

Cmv Infection ◽

Pcr Assay ◽

Hospital System ◽

Congenital Cmv Infection ◽

Congenital Cmv

Abstract Background Congenital CMV infection (cCMV) is the most common identifiable cause of mental retardation in the United States but requires early diagnosis to define the infection and to institute effective antiviral therapy. Traditional identification strategies including hearing screens and physical exams likely miss many patients with cCMV. We therefore developed and evaluated the performance of a PCR assay optimized for low cost, specimen collection at time of dried blood spot collection, and detection thresholds below the salivary CMV concentrations known to occur in cCMV patients. Methods We utilized a real-time CMV PCR assay (SimplexaTM CMV)(DiaSorin, Cypress CA) amplifying the UL83 gene and the 3M Integrated Cycler. Saliva was collected from volunteers (Copan swab), and spiked with known concentrations of CMV culture supernatant quantified by COBAS AmpliprepTM. (Roche Diagnostics). Additionally, saliva was collected by copan swab from all births within a single multi-hospital system from 3/21/16 – 5/4/17. Newborns who were initial screen PCR positive were subsequently evaluated by urine CMV PCR by an outside laboratory for confirmation of cCMV. Results Analytical threshold of detection was well below 4 log copies/ML, with 100% of samples testing positive at 3.5 log copies/ML (Fig 1). 6127 newborn saliva samples were evaluated and 61 were PCR positive (£40 CT). 47 of these tests were confirmed by urine PCR (Fig 2) (PPV 0.9792, NPV 0.9988, Sens 0.8704, Spec 0.9998). Screen positive tests which were not confirmed by urine PCR had CT values £36. Adjusting the definition of a positive to CT £36 further improved the performance (PPV >0.9999, NPV 0.9997, Sens 0.9592, Spec >0.9999). Conclusion We demonstrate good performance of a congenital CMV methodology thus facilitating an effective universal newborn screening program Disclosures J. P. Devincenzo, AstraZeneca/MedImmune: Investigator, Research support

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Valganciclovir Use Among Commercially and Medicaid-insured Infants With Congenital CMV Infection in the United States, 2009–2015

Clinical Therapeutics ◽

10.1016/j.clinthera.2018.01.006 ◽

2018 ◽

Vol 40 (3) ◽

pp. 430-439.e1 ◽

Cited By ~ 4

Author(s):

Jessica Leung ◽

Sheila C. Dollard ◽

Scott D. Grosse ◽

Winnie Chung ◽

ThuyQuynh Do ◽

...

Keyword(s):

United States ◽

The United States ◽

Cmv Infection ◽

Congenital Cmv Infection ◽

Congenital Cmv

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CONGENITAL CMV INFECTION - LONDON DIAGNOSIS AND TREATMENT AUDIT 2013-2016

10.26226/morressier.58fa1767d462b80290b515fb ◽

2017 ◽

Author(s):

Ann-Marie Buckley

Keyword(s):

Diagnosis And Treatment ◽

Cmv Infection ◽

Congenital Cmv Infection ◽

Congenital Cmv

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COMPARATIVE EVALUATION OF ILLUMIGENE® CMV ASSAY AND REAL TIME COMMERCIAL KIT FOR THE NEONATAL SCREENING OF CONGENITAL CMV INFECTION IN SALIVA SAMPLES

10.26226/morressier.58fa1767d462b80290b51782 ◽

2017 ◽

Author(s):

Tiziana Lazzarotto

Keyword(s):

Real Time ◽

Neonatal Screening ◽

Comparative Evaluation ◽

Cmv Infection ◽

Congenital Cmv Infection ◽

Commercial Kit ◽

Congenital Cmv

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Faculty Opinions recommendation of Cytomegalovirus (CMV) Enzyme-Linked Immunosorbent Spot Assay but Not CMV QuantiFERON Assay Is a Novel Biomarker To Determine Risk of Congenital CMV Infection in Pregnant Women.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726410871.793527209 ◽

2017 ◽

Author(s):

Vincent Emery

Keyword(s):

Pregnant Women ◽

Cmv Infection ◽

Congenital Cmv Infection ◽

Congenital Cmv

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Perinatal Mood and Anxiety Disorder Management in Multicenter Community Practices: Clinicians’ Training, Current Practices and Perceived Strategies to Improve Future Implementation

Journal of Primary Care & Community Health ◽

10.1177/2150132721996888 ◽

2021 ◽

Vol 12 ◽

pp. 215013272199688

Author(s):

Ajeng J. Puspitasari ◽

Dagoberto Heredia ◽

Elise Weber ◽

Hannah K Betcher ◽

Brandon J. Coombes ◽

...

Keyword(s):

Anxiety Disorder ◽

Health Services ◽

Behavioral Health ◽

Psychiatric Symptoms ◽

Medical Center ◽

Academic Medical Center ◽

Management Training ◽

The United States ◽

Behavioral Health Services ◽

Perinatal Women

Background: This study aimed to explore clinicians’ perspectives on the current practice of perinatal mood and anxiety disorder (PMAD) management and strategies to improve future implementation. Methods: This study had a cross-sectional, descriptive design. A 35-item electronic survey was sent to clinicians (N = 118) who treated perinatal women and practiced at several community clinics at an academic medical center in the United States. Results: Among clinicians who provided care for perinatal women, 34.7% reported never receiving PMAD management training and 66.3% had less than 10 years of experience. Out of 10 patients who reported psychiatric symptoms, 47.8% of clinicians on average reported providing PMAD management to 1 to 3 patients and 40.7% noted that they conducted screening only when patient expresses PMAD symptoms. Suggested future improvements were providing training, developing a referral list, and establishing integrated behavioral health services. Conclusions: Results from this study indicated that while PMAD screening and management was implemented, improvements are warranted to meet established guidelines. Additionally, clinicians endorsed providing PMAD management to a small percentage of perinatal patients. Suggested strategies to increase adoption and implementation of PMAD management should be explored to improve access to behavioral health services for perinatal women.

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