Screening and diagnosis of congenital cytomegalovirus infection: A 5-y study

Although cytomegalovirus infection is the most common infection transmitted via the placenta, there are no guidelines for routine screening to detect children congenitally infected with cytomegalovirus. From 1993 to 1997, mat ernal serum and cord vein blood of newborns was screened for HCMV-IgM (n = 21,183). Urine was examined for HCMV-excretion during the first postnatal w eek to prove HCMV infection in children who expressed HCMV-IgM in cord vein blood (n = 13) or who were born to mothers positive for HCMV-IgM in the se rum (n = 234), or when both ford vein blood and maternal serum were positiv e for HCMV-IgM (n = 6). Congenital HCMV infection was detected in 17 newbor ns. To determine the incidence of congenital HCMV infection, only those mot her/child pairs were selected in whom serum and cord vein blood were invest igated (n=5967 mother/child pairs). In this group 13 newborns were infected . The observed incidence for congenital HCMV infection is 0.21%. It is conc luded that that this screening programme will detect those children at risk for congenital HCMV infection. These children have to be examined for viru s excretion in the urine. Although the observed incidence is only 0.21%, co ngenital HCMV infection is a problem that can no longer be neglected becaus e of its long-term sequelae.