Epidemiology of cytomegalovirus infection in pregnancy in Israel: Real-world data from a large healthcare organization.


Journal

Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876

Informations de publication

Date de publication:
02 2022
Historique:
revised: 30 09 2021
received: 20 05 2021
accepted: 16 10 2021
pubmed: 20 10 2021
medline: 9 2 2022
entrez: 19 10 2021
Statut: ppublish

Résumé

Congenital cytomegalovirus infection (cCMVi) is the leading cause of nonhereditary sensorineural hearing loss among newborns. Women newly acquiring cytomegalovirus infection (CMVi) during pregnancy have the highest risk of vertical transmission. This study aimed to describe the epidemiology of CMVi in pregnancy in a large healthcare database. A retrospective cohort study was performed using the Maccabi Healthcare Services database (Israel). Women aged 18-44 years old on July 1, 2013 with no record of pregnancy in the prior 6 months were followed through December 31, 2017 for first pregnancy occurrence. Pregnancy outcomes (live birth, spontaneous/therapeutic abortions, stillbirth, and uncertain outcomes) were captured. CMV test results were obtained to assess serostatus at the start of pregnancy (SoP) and primary CMV infection (CMVi) during pregnancy. Associations of demographic and reproductive factors with pCMVi were investigated (multivariable logistic regression). The study included 84 699 pregnant women (median age = 31 years; interquartile range = 28-35). Live birth, fetal loss, and uncertain pregnancy outcomes accounted for 76.8%, 18.2%, and 5.0%, respectively. The seroprevalence of CMV at the start of pregnancy in this cohort was 63.4% (95% confidence interval [CI]: 63.1-63.7). Among seronegative women with available test results (n = 10 657), CMVi incidence was 14.5 per 1000 (95% CI = 12.2-16.7). In multivariate logistic regression models adjusting for maternal age, CMVi was significantly associated with having one or more prior live births (odds ratio [OR]: 3.8 [95% CI: 2.6-5.4]) and having a child less than 6 years of age (OR: 4.3 [95%CI: 3.0-6.1]). One in three pregnant women in Israel is at risk for primary CMVi. This study demonstrates that real-world electronic healthcare data can be leveraged to support clinical management and development of interventions for congenital CMV by identifying women at high risk for CMVi during pregnancy.

Identifiants

pubmed: 34665462
doi: 10.1002/jmv.27403
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

713-719

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

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Auteurs

Clara Weil (C)

Maccabi Institute for Research and Innovation (Maccabitech), Maccabi Healthcare Services, Tel Aviv, Israel.

Efraim Bilavsky (E)

Schneider Children's Medical Center, Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Anushua Sinha (A)

Merck & Co., Inc., Kenilworth, New Jersey, USA.

Gabriel Chodick (G)

Maccabi Institute for Research and Innovation (Maccabitech), Maccabi Healthcare Services, Tel Aviv, Israel.
Schneider Children's Medical Center, Petah Tikva, Israel.

Elizabeth Goodman (E)

Merck & Co., Inc., Kenilworth, New Jersey, USA.

Wei Vivian Wang (WV)

Merck & Co., Inc., Kenilworth, New Jersey, USA.

Shawna R Calhoun (SR)

Merck & Co., Inc., Kenilworth, New Jersey, USA.

Morgan A Marks (MA)

Merck & Co., Inc., Kenilworth, New Jersey, USA.

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