Year: 2025
Type: letter
Abstract: Re: Management of cytomegalovirus infection in pregnancyDear Editor, We read with interest the comprehensive review by Kalogeropoulou et al. on the management of cytomegalovirus infection in pregnancy.The article discusses the use of valaciclovir in the first trimester to reduce the risk of maternalfetal transmission after primary maternal cytomegalovirus (CMV) infection.1 It is accepted that large-scale high-quality studies are needed to validate the data and to accurately define the group of pregnant women who would benefit most from such interventions.However, these developments call for a better screening method to identify pregnancies at risk at an appropriate gestational age. 2 Although the United Kingdom currently does not have a screening programme for CMV, we would like to highlight the promising developments for screening for CMV infection using noninvasive prenatal testing (NIPT).Peddu et al. have shown that whole-genome cell-free DNA (cfDNA) sequencing, performed for NIPT, can discover fragments of human cytomegalovirus (hCMV) with high sensitivity.3 Chesnais et al. discovered very low viral loads of hCMV in the cfDNA correlated with positive CMV infection.They suggested that as low viral loads are detected using the same sequencing method as the established NIPT, it opens the way to a relatively low-cost combined screening test.4 Faas et al. performed a retrospective study of the NIPT data on a large cohort (204,818) of pregnant women in the Netherlands.The study shows pre-screening for both genetic fetal aberrations and active maternal hCMV infections during pregnancy can be combined in one cfDNA sequencing test, on a single blood sample, in the first trimester.In 1930 samples (0.94%), hCMV fragments were detected in the cellfree DNA.This showed these pregnancies had an active infection, either primary or re-activated.2 Validation by hCMV qPCR showed that samples with high cfDNA-hCMV load tested positive and cfDNA hCMV-negative samples tested negative.In 32/112 cfDNA-hCMV positive samples (28.6%), the serological profile suggested a recent
Source: The Obstetrician & Gynaecologist
DOI: 10.1111/tog.70022
Authors: Emily Hewit, Abha Govind
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4417506143