Objectives
Approximately 5-10% of fetal growth restriction (estimated weight less than 10th percentile for gestational age) has been attributed to intrauterine infections, particularly CMV. The purpose of this study was to investigate the prevalence of CMV infection by PCR in placentas from infants born with unexplained small for gestational age birth weights.
Methods
A retrospective cohort of SGA neonates was collected from the delivery database of a suburban tertiary care center. SGA infants were identified according to previously established sex-specific weight standards (Kramer 2001). The corresponding gestational age at delivery, birth weight, maternal and neonatal laboratory results for infectious diseases (CMV, toxoplasmosis, and parvovirus), maternal medical & surgical history, and maternal medication and drug use were collected from the electronic medical record system. Pregnancies complicated by multiple gestation, fetal anomalies, maternal hypertension/preeclampsia or diabetes, abnormal cord insertion, and maternal tobacco use were excluded. A total of 1577 SGA infants were born between 1/11/2011 and 11/12/2014, 868 of whom had placental pathology available. For this pilot study, 58 of the most recently delivered subjects were selected for review to obtain a cohort of 25 cases of unexplained SGA neonates. PCR for CMV DNA was performed using an in-house real-time PCR assay performed on a Light Cycler utilizing FRET probes for fluorescent detection. DNA was prepared from deparaffinized sections of formalin fixed, paraffin embedded placenta, and was evaluated for successful amplification of a 200 bp fragment of human DNA prior to CMV PCR.
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