How to avoid pregnancy infection with cytomegalovirus (CMV)?
Cytomegalovirus or CMV for short is a virus of the herpes family, which is responsible for a number of clinical syndromes including kissing disease.
But a maternal infection in pregnancy, especially in the first trimester, can pass to the fetus and injure it and cause what is called a congenital CMV infection.
Therefore, if we could prevent a pregnant woman, especially in early pregnancy, from contracting this virus we would save her a lot of headache and potential for fetal problems.
But first of all, one must differentiate between primary and non-primary (secondary) maternal infection, let’s learn together what these concepts mean.
What is a primary infection and what is a non-primary infection in pregnancy?
According to several epidemiological studies in our country, about 75% of women of childbearing age have been infected with CMV in the past. Some know and remember that they have been ill but most do not remember being infected. This old infection can be detected by taking an antibody test taken in early pregnancy.
It follows that about 25% of women become pregnant without antibodies.
Primary infection in pregnancy – A woman who has not been infected with this virus in the past and was first infected during pregnancy. Because it has no antibodies, the infection may be passed through the placenta to the fetus and endanger it especially if it happens in the early stages of pregnancy.
Non-primary infection in pregnancy – A woman with antibodies (previously infected with this virus) but her old virus "raised its head" in pregnancy and infected it again, or was infected again with a slightly different type of CMV. In this case, too, a transfer to the fetus is possible, although the chance of injury is much lower than in a primary infection.
Can primary CMV infection be prevented in pregnancy?
Most infections are known to occur due to the pregnant woman’s contact with children in the home, usually preschoolers. Remember that children, who sometimes contract CMV quietly, excrete large amounts of the virus in saliva and urine.
A cool Italian work published a few years ago has aggressively demonstrated that primary infection in pregnancy can be prevented by maintaining four steps.
1. Washing hands with soap and water after contact with small children’s secretions (contact with saliva, nasal cleansing, diaper change, etc.).
2. Wash hands after contact with surfaces touched by small children (toys, chairs, etc.).
3. Avoid kissing small children in the mouth / cheek area. It is possible and recommended to kiss in the forehead area.
4. Do not share food, drink, utensils and towels with small children.
For anyone who finds these four steps too drastic, you do not want to be under the stress and strain of pregnancy with CMV, even if the results are usually great and the fetus is not infected or not sick.
Can non-primary CMV infection be prevented during pregnancy?
As I explained earlier a non-primary infection can happen in two mechanisms:
Awakening of the same virus that has been latent (hidden) in the mother since the initial infection – this can not be prevented.
New CMV infection – can be prevented by following the same four steps.
Was and is there a CMV infection during pregnancy?
In such a case, I really recommend visiting the excellent website of the Israeli Pregnancy Association with CMV. This is a site written in blood, sweat and tears by amazing women who got pregnant with CMV. You can log in by clicking on This link .
This site also summarizes an original Israeli article that demonstrates efficacy in the treatment of valacyclovir in women after premature infection in pregnancy. Read more At the following link.
But remember that preventing a disease is better than dealing with it, so be sure to follow the four steps and let’s reduce the incidence of congenital CMV infection together.