Objectives
Data pertaining to the association between congenital CMV infection and spontaneous preterm birth (SPTB) is limited. Given that infection may lead to inflammation during pregnancy and to placental abnormalities, we hypothesized that pregnancies with congenital CMV infection may be at increased risk for SPTB and abnormal placental markers.
Methods
We conducted a case-control study of singleton pregnancies with second trimester screening in California in 2005-2010 who had infants with and without diagnosed congenital CMV infection reported in delivery discharge records. Controls were randomly chosen at a ratio of 4:1 from all infants without CMV infection. We assessed SPTB and compared placental markers in these groups. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Methods
We conducted a case-control study of singleton pregnancies with second trimester screening in California in 2005-2010 who had infants with and without diagnosed congenital CMV infection reported in delivery discharge records. Controls were randomly chosen at a ratio of 4:1 from all infants without CMV infection. We assessed SPTB and compared placental markers in these groups. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Results
A total of 64 of 1,057,032 infants were identified with congenital CMV infection. The overall rate of SPTB was 42.2% (27/64) in the infants with congenital CMV infection compared to 7.0% (18/256) in those without infection. Infants diagnosed with congenital CMV infection were nearly 15 times more likely to be born due to SPTB at <37 weeks of gestation compared to those without this infection diagnosis (OR 14.8, 95% CI 6.5, 33.6). (Table) Pregnancies resulting in PTB with or without an infant with congenital CMV were more likely to exhibit one or more second trimester abnormal placental marker (alpha-fetoprotein, human gonadotrophin, or inhibin ≥ the 90th or unconjugated estriol [uE3] ≤ the 10th percentile) compared to control term births (48.2% in PTBs with CMV and 50.0% in PTBs without CMV versus 25.2% in term controls). Furthermore, PTBs with CMV were more likely to have uE3 levels ≤ the 10th percentile (25.9%) versus non-CMV PTB (5.6%) and term controls (8.0%).
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