Cytomegalovirus Infection Risks in Pregnant Women in Taiwan - Obstetrics and Gynecology

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Cytomegalovirus (CMV) infection is a significant concern during pregnancy, particularly due to its potential impact on both the mother and the developing fetus. In Taiwan, as in many other countries, the prevalence of CMV infection among pregnant women and newborns can vary, but it is generally recognized that a substantial percentage of women of childbearing age have been exposed to the virus. Studies indicate that over 50% of adults may have CMV antibodies, suggesting prior infection, but this does not necessarily correlate with active infection during pregnancy.

CMV is primarily transmitted through bodily fluids, including saliva, urine, blood, breast milk, and sexual contact. While sharing utensils, such as not using public chopsticks or mother spoons, can theoretically increase the risk of transmission, the primary concern for pregnant women is usually related to direct contact with infected bodily fluids, particularly from young children who may shed the virus in their saliva and urine. Therefore, practicing good hygiene, such as frequent handwashing and avoiding sharing utensils, can help reduce the risk of infection.

Currently, routine screening for CMV during pregnancy is not standard practice in many countries, including Taiwan. This is largely due to the fact that while serological testing can detect antibodies, it does not confirm active infection or predict transmission to the fetus. Only a small percentage of women with primary CMV infection during pregnancy will transmit the virus to their fetus, and among those, only a fraction will experience significant complications.

When a fetus is infected with CMV, ultrasound findings may reveal abnormalities, which can include intracranial calcifications, ventriculomegaly, growth restriction, and placental enlargement. These findings can vary depending on the timing of the infection during pregnancy. In general, infections that occur in the first trimester are associated with a higher risk of severe outcomes, including congenital CMV syndrome, which can lead to long-term developmental issues. Infections that occur later in pregnancy may still pose risks but are often less severe.

In summary, while the risk of CMV infection in pregnant women in Taiwan is notable, the actual transmission to the fetus is relatively low, and the severity of potential outcomes is influenced by the timing of the infection. Pregnant women should be educated about the risks and encouraged to practice good hygiene to minimize exposure. Regular prenatal care and discussions with healthcare providers can help manage concerns and monitor fetal health effectively. If there are any specific concerns about CMV or other infections during pregnancy, it is essential to consult with a healthcare professional for personalized advice and management.