Risk factors associated with vertical transmission of CMV in Southern
Brazil: a cross-sectional study based on the molecular prevalence of the
virus in placental tissue and umbilical blood cord
Abstract
Objective: This study estimated CMV molecular prevalence in
placental biopsies as well as in umbilical blood cord and its
correlation with infection of pregnant women and their newborns to
determinate vertical transmission risks. Design: A
cross-sectional study Setting: Obstetric Center of the
University Hospital in Rio Grande, Brazil Population: 496
pregnant women and their newborns Methods: Biopsies were
collected from peripheral and central portions of each placenta,
separated on fetal and maternal interfaces, matched with cord blood,
totaling 1488 samples. PCR technique and sequencing were used to
investigate the prevalence. Main Outcome Measures: Bivariate
and multivariate analysis were performed to determinate
sociodemographic, clinical and gynecological data associated to CMV
vertical transmission. Results: CMV DNA was found in 5.2% of
placental maternal interface and 5.4% of fetal interface with a
positive result for CMV in 3.6% in cord blood. In more than 90% of the
cases, there was no match between positive CMV DNA cord blood and
positive placentas, indicating vertical transmission ascending from
genital tract. The income factor (less than 1 minimum wage) was
significantly associated with prevalence of CMV in placentas (p = 0.03).
In cord blood samples, non-white skin color and early age at the onset
of sexual intercourse were risk factors associated with the infection (p
= 0.04). Conclusions: The occurrence of CMV DNA found in cord
blood suggests the pattern observed appears to be ascending from genital
tract of asymptomatic mothers. Economical and environmental factors
present a negative impact on fetal-maternal transmission of
cytomegalovirus.