Cytomegalovirus, a Common Cause of Intrauterine Infection: A Case - Control Study in Tehran, Iran

Background and Aim: Congenital cytomegalovirus (CMV) infection affects~1% of live births in the United States. Ten percent of these infants have symptoms at birth and another 10 to 15% develop hearing loss or developmental problems.The aim of this study was to compare CMV infection (IgM and IgG) in infants suspected for intrauterine infection with the controls.
Materials and Methods: A case control study was performed in the Pediatrics department of Hazrat Rasool Akram Hospital in Tehran (2002-2003). We compared the serum CMV antibodies (IgM &IgG-ELISA) of 74 cases suspected of intrauterine infection (mean age =4.7r3.7 months) with that of 65 controls (mean age=5.3r3.1 months).
Results: Acute and previous immunity to CMV (IgM and IgG ) was found in 41.9% (31/74) and 74% (54/74) of the cases, respectively. Meanwhile acute infection (IgM) was observed in 6.2% (4/65) and previous immunity (IgG) in 95.4% (62/65) of the controls. Acute infection (CMV-IgM) was higher in cases (p-value=0.000), but previous immunity (CMV-IgG) was higher in the controls (p value=0.001).
Conclusion: We conclude that like other countries, CMV is the most common cause of intrauterine infection in infants aged less than 6 months as compared to the healthy ones.We prefer, at least in our country, to consider seropositive (CMV-IgM) infants suspected of intrauterine infection (less than 6 months) as congenital form.To arrest the natural progression of congenital CMV, we recommend prolonged course of oral analogues of ganciclovir for children with symptomatic congenital CMV.