Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Antibody and DNA Tests
2.2. Maternal Screening Program and Neurological Tests in cCMV Infants
2.3. Comparison of Maternal Screening with the Original and Revised Cutoffs of CMV IgM Antibody Titer
3. Results
3.1. Maternal Screening with Revised Cutoff of CMV IgM Antibody Titer and Infant cCMV
3.2. Revised Versus Original Cutoff of CMV IgM Antibody Titer
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No. | Maternal Age (Year) | Maternal Parity (Para) | Result of Maternal Antibody Screening | Titer of IgM at Early Pregnancy (Index) | Avidity Index of IgG at Early Pregnancy (%) | GW of Maternal Antibody Tests in Early/Late Pregnancy (Week) | GW of Delivery (Week) | Delivery Mode | Infant Sex | Infant Body Weight at Birth (g) | Infant Height at Birth (cm) | Infant HC at Birth (cm) | Infant Apgar Scores at 1, 5 min | UA pH | Universal Newborn Hearing Screening | Amount of CMV DNA in Neonatal Urine (log10) (Copy/mL) | Viral Isolation of Neonatal Urine | Subunit of gB | Infant Abnormal Neurological Tests |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 24 | 2 | Low IgG avidity | 12.00 | 2.2 | 10/- | 38 + 6 | Vaginal | Male | 2930 | 50.0 | 32.0 | 9, 10 | 7.309 | Pass | 6 | + | 1 | - |
2 | 30 | 1 | Low IgG avidity | 8.49 | 11.4 | 10/- | 39 + 6 | Vaginal | Male | 3102 | 50.0 | 33.4 | 9, 10 | 7.349 | Pass | 4 | + | 3 | - |
3 | 30 | 0 | Low IgG avidity | 7.74 | 31.9 | 11/- | 37 + 5 | Vacuum | Male | 3090 | 51.0 | 33.5 | 3, 9 | 7.068 | Left refer | 4 | + | 3 | MRI + ABR |
4 | 26 | 0 | Low IgG avidity | 9.72 | 0.0 | 7/- | 41 + 3 | Vaginal | Male | 2930 | 48.0 | 32.0 | 10, 10 | 7.360 | Pass | 7 | + | 3 | - |
5 | 22 | 1 | Low IgG avidity | 12.00 | 2.5 | 13/- | 39 + 3 | Vaginal | Female | 2816 | 48.3 | 32.0 | 9, 10 | 7.284 | Pass | 6 | + | 1 | - |
6 | 24 | 0 | Low IgG avidity | 12.00 | 2.5 | 10/- | 40 + 2 | Vaginal | Male | 3482 | 49.5 | 32.0 | 8, 10 | 7.236 | Bilateral refer | 4 | - | 1 | ABR |
7 | 32 | 1 | Low IgG avidity | 12.00 | 4.5 | 11/- | 39 + 4 | Vaginal | Female | 3008 | 48.0 | 33.0 | 10, 10 | 7.367 | Pass | 5 | + | 1 | - |
8 | 20 | 1 | IgG seroconversion | - | - | 12/34 | 39 + 1 | Vaginal | Male | 3496 | 50.3 | 34.0 | 10, 10 | 7.340 | Pass | 6 | + | 1 | - |
9 | 27 | 1 | IgG seroconversion | - | - | 11/43 * | 38 + 1 | Vaginal | Female | 2458 | 49.0 | 30.0 | 10, 10 | 7.460 | Right refer | 3 | + | 1 | ABR ** |
10 | 30 | 1 | IgG seroconversion | - | - | 8/36 | 39 + 5 | Vaginal | Male | 3512 | 50.5 | 33.3 | 9, 10 | 7.462 | Pass | 4 | + | 3 | - |
11 | 22 | 0 | IgG seroconversion | - | - | 12/34 | 41 + 0 | Vaginal | Male | 4006 | 51.0 | 36.0 | 9, 10 | 7.276 | Pass | 6 | - | 3 | - |
12 | 35 | 1 | IgG seroconversion | - | - | 16/36 | 39 + 5 | Vaginal | Female | 3428 | 49.0 | 35.5 | 8, 9 | 7.273 | Pass | 6 | + | 1 | - |
13 | 26 | 1 | High IgG avidity | 3.68 | 76.6 | 14/- | 22 + 1 | Abortion | Male | 476 | 25.0 | 18.0 | - | - | - | 5 (Ascites) | -(Ascites) | - | - |
14 | 27 | 2 | High IgG avidity | 2.17 | 77.3 | 9/- | 40 + 1 | Vaginal | Female | 3134 | 50.0 | 33.0 | 10, 10 | 7.297 | Pass | 4 | + | 1 | ABR |
Results of Maternal CMV Antibody Screening | Number of Pregnant Women | Number of Neonatal Urine CMV DNA Tests | Number of cCMV Cases Including Symptomatic cCMV | Number of Symptomatic cCMV Cases |
---|---|---|---|---|
Positive * IgG, IgM above the revised cutoff, and high IgG avidity | 209 | 71 | 0 | 0 |
Positive * IgG, IgM under the revised cutoff, and high IgG avidity | 805 | 48 | 2 | 2 |
Positive * IgG, IgM under the revised cutoff, and unknown IgG avidity | 595 | 126 | 0 | 0 |
Positive * IgG and negative * IgM | 18,962 | 146 | 0 | 0 |
Study Period | April 2017–March 2019 | September 2013–March 2017 | p Value |
---|---|---|---|
Cutoff of CMV IgM titer to measure IgG avidity as a reflex test in maternal antibody screening program | The revised cutoff (≥4.00 index) of CMV IgM titer | The original cutoff (≥1.21 index) of CMV IgM titer | |
Total number of participating pregnant women | 12,832 | 19,435 | |
Number of pregnant women with positive CMV IgG * and IgM above the original cutoff (≥1.21 index of IgM titer) | 722 (5.6%) | 1037 (5.3%) | 0.26 |
Number of pregnant women with positive CMV IgG * and IgM above the revised cutoff (≥4.00 index of IgM titer) | 127 (1.0%) | 184 (1.0%) | 0.73 |
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Kitamura, A.; Toriyabe, K.; Hagimoto-Akasaka, M.; Hamasaki-Shimada, K.; Ikejiri, M.; Minematsu, T.; Suga, S.; Kondo, E.; Kihira, M.; Morikawa, F.; et al. Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women. Viruses 2023, 15, 962. https://doi.org/10.3390/v15040962
Kitamura A, Toriyabe K, Hagimoto-Akasaka M, Hamasaki-Shimada K, Ikejiri M, Minematsu T, Suga S, Kondo E, Kihira M, Morikawa F, et al. Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women. Viruses. 2023; 15(4):962. https://doi.org/10.3390/v15040962
Chicago/Turabian StyleKitamura, Asa, Kuniaki Toriyabe, Miki Hagimoto-Akasaka, Kyoko Hamasaki-Shimada, Makoto Ikejiri, Toshio Minematsu, Shigeru Suga, Eiji Kondo, Masamichi Kihira, Fumihiro Morikawa, and et al. 2023. "Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women" Viruses 15, no. 4: 962. https://doi.org/10.3390/v15040962
APA StyleKitamura, A., Toriyabe, K., Hagimoto-Akasaka, M., Hamasaki-Shimada, K., Ikejiri, M., Minematsu, T., Suga, S., Kondo, E., Kihira, M., Morikawa, F., & Ikeda, T. (2023). Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women. Viruses, 15(4), 962. https://doi.org/10.3390/v15040962