Understanding CMV and its potential risks in pregnancy
When you are planning to start your family or in the early stages of your pregnancy, you will be given advice about how to keep you and your baby healthy. However, very few women receive information about strategies to reduce their risk of infection of a virus called CMV (cytomegalovirus) which can pose serious health risks to developing babies.
What is CMV?
Cytomegalovirus is a herpes virus that is spread through contact with saliva, urine, or genital secretions. Most healthy people who contract the virus will have no symptoms or may exhibit mild flu-like symptoms such as fatigue, sore throat, fever or swollen glands.
When a person gets CMV infection for the first time, it’s called a primary infection. Like other herpesviruses, CMV remains dormant in the host for the rest of their lives and can be reactivated during times of compromised immunity – like during pregnancy.
If a pregnant woman gets CMV just before or during pregnancy, the virus can be passed to her unborn baby, causing congenital CMV. Whilst most babies born with congenital CMV will be healthy, it can cause sensorineural deafness, vision loss, intellectual impairment, cerebral palsy, seizures and in rare cases, stillbirth and infant death.
How common is CMV?
Aliza Carr – Registered midwife and founder of Bumpnbub – told us that “By the time individuals reach young adulthood, approximately 50% have been infected with CMV, and this number increases to around 85% by the age of 40.”
Congenital CMV, whilst little known, is more common than you might think. Over 400 Australian born babies a year have life-long disabilities as a result of congenital cytomegalovirus , making it the leading infectious (and preventable) cause of disabilities in newborn babies.
According to NSW Health, studies in Australia have shown that out of 1,000 live births, about 6 infants will have congenital CMV infection and 1-2 of those 6 infants (about 1 in 1000 infants overall) will have permanent disabilities of varying degree. These can include hearing loss, vision loss, cerebral palsy, developmental delay or intellectual disability, and in rare cases, death.
“In cases where a primary infection of cytomegalovirus occurs during the first trimester, there is a heightened likelihood of complications affecting the unborn baby,” says Aliza.
And yet, less than 20% of pregnant women have heard of Cytomegalovirus and only 10% of maternity health professionals routinely counsel pregnant women about the risks of cytomegalovirus .
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Who is most at risk of CMV infection?
Midwife Aliza says that according to research, individuals most at risk of contracting Cytomegalovirus include:
- Individuals who take care of or work with young children, through activities like changing nappies.
How can CMV be prevented?
While Cytomegalovirus cannot be prevented entirely, there are simple hygiene precautions that women can take to reduce their risk of cytomegalovirus in pregnancy:
- Wash with care – wash hands carefully after changing nappies and wiping noses
- Kiss with care – whilst you are pregnant, avoid kissing toddlers on the lips. Kiss on the forehead instead.
- Don’t share – don’t share food, cups or cutlery with young children and avoid putting your child’s dummy/toothbrush in your mouth
- Clean with care – Wash and sanitise toys frequently – especially if your child takes them to daycare
What are the signs of congenital CMV?
Some signs that a baby might have congenital CMV infection when they are born are:
- Small head size
- Seizures
- Rash
- Liver, spleen, and lung problems
Tests on a baby’s saliva, urine, or blood done within two to three weeks after birth can confirm if the baby has congenital cytomegalovirus .
Screening for CMV in pregnancy
Health authorities in Australia do not currently recommend universal serological screening of CMV in pregnancy, however it is recommended that all pregnant women and families planning a pregnancy be provided advice on how to avoid cytomegalovirus infection during pregnancy.
“It is important to discuss CMV with all pregnant couples, or couples seeking preconception care”, says Aliza. “cytomegalovirus can pose significant risks to unborn babies particularly if the mother contracts the virus during pregnancy. Having open and informative discussions about CMV can help raise awareness about the virus, its transmission methods, and the simple preventive measures that can be taken to reduce the risk of infection.”
The Australian Dept of Health and the Royal Australian College of Obstetrics and Gynecology (RANZCOG) recommends “Pre-pregnancy or early pregnancy screening with CMV IgG may be considered for women who are at high risk of infection”. They also recommend testing for pregnant women if they have “symptoms suggestive of cytomegalovirus that are not attributable to another specific infection or when imaging findings suggest fetal infection”.
For more information, or if you have any concerns, chat to your GP or maternity health professional.
Please head to cerebralpalsy.org.au/cmv for more information on CMV.
Aliza Carr is a registered midwife and the founder of Bumpnbub. You can follow her on Instagram here.
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