Reinfection with cytomegalovirus during pregnancy: a prospective cohort
study in Canada
Abstract
Background: Congenital cytomegalovirus infections (cCMV) are an
important cause of childhood neurodevelopmental deficits. Most cCMV are
the result of maternal non-primary infections during pregnancy, which
can be due to reactivation or reinfection. Objective: To
identify the rate of CMV reinfection during pregnancy and its risk
factors. Study Design: We performed a secondary analysis of CMV
seropositive participants from two prospective cohort studies in Quebec,
Canada. Antibody responses to four strain-specific CMV epitopes located
in glycoproteins B and H were measured by enzyme-linked immunosorbent
assay. CMV reinfection was defined as the appearance of an antibody
response to a new epitope in the third compared to the first trimester.
Risk factors for reinfection were assessed. Results: Among 1614
participants, CMV reinfection was identified in 2.7% of participants,
representing an incidence of 54.99 per 1000 person-years at risk (95%
confidence interval 39.95-73.82). Age, marital status, household income,
continent of birth or ethnicity were not associated with reinfection
during pregnancy. Conclusions: The incidence of CMV reinfection
during pregnancy is like what has been reported for primary infection in
Quebec. A greater understanding of the patterns of reinfection is needed
to inform strategies to reduce the burden of disease from cCMV.