Symptomatic congenital cytomegalovirus infection in infants born to mothers with preexisting immunity to cytomegalovirus

Objectives. To determine the frequency of symptomatic congenital cytomegalo virus (CMV) infection in the offspring of women with a recurrent maternal C MV infection and to characterize the demographic and newborn findings. Methods. Study subjects consisted of infants with symptomatic congenital CM V infection identified by a newborn virologic screening program at the Univ ersity of Alabama Hospital between 1991 and 1997 and were enrolled in a lon g-term follow-up study. Maternal infections were categorized by an analysis of archival serum specimens collected before pregnancy and at the time of delivery. Demographic data and clinical findings at birth were collected fr om maternal and newborn hospital records and from parents at the time of in itial evaluation. Results. Of the 47 infants with symptomatic congenital CMV infection identi fied during the study period, 8 were born to mothers with a confirmed nonpr imary or recurrent CMV infection. The type of maternal infection could be a scertained in only similar to 43% (20/47) of the children with symptomatic congenital CMV infection born at the University of Alabama Hospital during the study period. There were no significant differences in demographic char acteristics of the recurrent infection group and the infants who were born to mothers with either primary CMV infection during pregnancy or unclassifi ed maternal infection. Similarly, the range of severity of clinical abnorma lities during the newborn period did not differ in the two groups of childr en. Furthermore, there were no significant differences in the incidence of sequelae at long-term follow-up in the two groups of children. Conclusions. Symptomatic congenital CMV infection can occur after a nonprim ary or recurrent maternal infection. However, the exact incidence of sympto matic congenital CMV infection among children born to women with preexistin g immunity remains to be defined.