Universal newborn screening for congenital cytomegalovirus infection: feasibility and relevance in a French type-III maternity cohort.
Congenital cytomegalovirus
neonatal screening
non-primary infection
saliva
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
accepted:
17
10
2021
pubmed:
3
11
2021
medline:
27
1
2022
entrez:
2
11
2021
Statut:
ppublish
Résumé
Evaluation of relevance and feasibility of universal newborn congenital cytomegalovirus infection (cCMVI) screening in saliva. Retrospective, population-based cohort study. Clamart, France, 2016-2020. All neonates born consecutively in our level III maternity unit. CMV PCR in saliva for all neonates at birth, and, if positive, CMV PCR in urine to confirm or exclude cCMVI. Prospective and retrospective characterisation of maternal infections. ROC curve analysis to assess saliva PCR performances. Acceptability of screening among staff members evaluated by a survey. Number of cCMVI neonates; number of expected and unexpected cCMVI. Among 15 341 tested neonates, 63 had cCMVI (birth prevalence of 0.4%, 95% CI 0.3-0.5). In 50% of cases, maternal infection was a non-primary infection (NPI) during pregnancy. cCMVI was expected or suspected (maternal primary infection [PI], antenatal or neonatal signs) in 24/63 neonates (38%), and unexpected in 39/63 neonates (62%). The best CMV saliva threshold to predict cCMVI was 356 (2.55 log) copies/ml [95% CI 2.52 log-3.18 log], with an area under the ROC curve of 0.97. Over 90% of the 72 surveyed staff members reported that the screening was easy and quick. No parent refused the screening. Universal screening for cCMVI with CMV PCR on saliva samples is feasible and highly acceptable to parents and healthcare providers. Over half (62%) of the cases had no prenatal/neonatal signs of cCMVI or a maternal history of CMV infection during pregnancy and would probably not have been diagnosed without universal screening. In 62% of congenital cytomegalovirus infection cases, only universal neonatal screening in saliva can detect infection.
Identifiants
pubmed: 34726316
doi: 10.1111/1471-0528.16992
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
291-299Informations de copyright
© 2021 John Wiley & Sons Ltd.
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