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Cytomegalovirus infection in pregnancy

Jeanne S Sheffield, MD
Suresh B Boppana, MD
Section Editors
Louise Wilkins-Haug, MD, PhD
Martin S Hirsch, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


Cytomegalovirus (CMV) is a ubiquitous DNA herpesvirus. As with other herpesviruses, it becomes latent after a primary infection but can reactivate with renewed viral shedding. Shedding can occur from multiple sites and for prolonged periods of time. Women can also become infected with a different viral strain.

CMV is the most common congenital viral infection, with birth prevalence of 0.48 to 1.3 percent in recent decades [1-4]. Congenital infection may be asymptomatic or symptomatic; symptomatic disease can be severe and life-threatening. Both asymptomatic and symptomatic newborns are at risk of developing long-term neurodevelopmental morbidity, particularly deafness.

This topic will discuss issues specific to CMV in pregnant and breastfeeding women. General issues related to CMV infection and CMV infections in other populations are reviewed separately. (See "Epidemiology, clinical manifestations, and treatment of cytomegalovirus infection in immunocompetent adults" and "Acquired cytomegalovirus infection in children" and "Congenital cytomegalovirus infection: Clinical features and diagnosis".)


Routes of transmission — Maternal acquisition of CMV infection can occur via multiple routes, including close nonsexual contact (including household and occupational exposure [especially contact with young children]), sexual exposure, transfusion, and organ transplant. CMV has been cultured from multiple body fluids, including urine, saliva, blood, nasopharyngeal secretions, tears, cervical and vaginal secretions, semen, and breast milk. Transmission from respiratory droplets or aerosolized droplets is unlikely [5]. (See "Epidemiology, clinical manifestations, and treatment of cytomegalovirus infection in immunocompetent adults", section on 'Transmission'.)

Seroprevalence — CMV infection is common: An epidemiologic study in the United States demonstrated seropositivity in approximately 58 percent of young women aged 15 to 44 years [3]. Seroprevalence increases with age, ranging from 50 to 100 percent, and varies by geographic residence, ethnicity, and socioeconomic factors [1-3]. The following characteristics are predictive of positive CMV serology:

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Literature review current through: Nov 2017. | This topic last updated: Nov 09, 2017.
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