If you are pregnant and want to know if you have a primary cytomegalovirus (CMV) infection, you can ask your OB/GYN for a blood test. In the past, however, there was little one could do with the results—even if they were positive. But now, there is currently a study underway to see if receiving CMV hyperimmune globulin (HIG) will prevent congenital CMV infection—a disease that causes more disabilities in unborn children than Down syndrome. If you are included in this current study, there is a 50% chance you will receive a placebo, because although HIG is promising, it is still unproven.
When I was pregnant with my daughter Elizabeth in 1989, I didn’t know the precautions to take to avoid contracting CMV—namely through careful hand washing when working with young children and their saliva and urine. That means a woman of childbearing age shouldn’t even kiss their own toddlers around the mouth. Young children are the majority of the carriers, and I not only ran a daycare center in my home when I was pregnant with Elizabeth, I had a toddler of my own. My darling Elizabeth was born severely disabled as a result of me passing the virus, which I did not know I had caught because it is often “silent,” onto her. She died when she was 16 during a seizure.
As a result of my work to raise a congenital CMV prevention message, which I hope will become as common as the “don’t change the kitty litter” rule when you are pregnant, I received the following e-mail from Brenna Anderson, M.D., M.Sc. She is Study Chair for a 14-center NICHD Maternal Fetal Medicine Units Network (MFMU) randomized clinical trial testing the efficacy and effectiveness of hyperimmune globulin for prevention of congenital CMV in women with primary infection:. She wrote to me:
“Cytomegalovirus (CMV) is the most common congenital infection, with a prevalence of approximately 1% in the United States, translating into 44,000 congenitally infected infants per year. A substantial proportion of these 44,000 infants will die or suffer permanent injury as a result of their infection. The severity of congenital infection is greatest with primary maternal CMV infection.
“Currently, there is no proven method of preventing congenital CMV infection, and the approach to primary maternal CMV infection in the United States is haphazard and ineffective. One small, non-randomized study suggests that maternal administration of CMV hyperimmune globulin may reduce the rate of congenital CMV infection following maternal primary infection.
“We are hoping that you will be willing to refer women that contact you who may have primary infection to our trial. I can receive the referrals for potentially infected women. I am happy to interact directly with the women if that is what they would prefer. Or I could simply provide contact information for the closest center in our trial.”
To learn more about the current study, visit: http://clinicaltrials.gov/ct2/show/NCT01376778?term=congenital+cmv&rank=4
Brenna Anderson, M.D., M.Sc.
Women & Infants Hospital of RI
101 Dudley Street
Providence, RI 02905
401-274-1122 ext. 7456