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The frequency of pregnancy and exposure to cytomegalovirus infections among women with a young child in day care

https://doi.org/10.1016/j.ajog.2008.08.037Get rights and content

Objective

The purpose of this study was to determine the frequency of pregnancy and exposure to cytomegalovirus (CMV) among mothers contemplating a possible additional pregnancy and with a child less than 2 years of age in group day care.

Study Design

We performed a prospective observational study that included a demographic questionnaire and serologic and virologic monitoring of mothers and their children in day care.

Results

Of 60 women, 62% were seronegative and 20% had a child shedding CMV. Of the 60 women, 23 women or 38% (95% CI, 0.27-0.51) became pregnant on average 10 months after enrollment. During pregnancy, 8 or 35% (95% CI, 0.19-0.55) of these pregnant women had a child in day care who shed CMV.

Conclusion

These results illustrate the potential magnitude of the public problem associated with exposure to a silent viral infection during pregnancy. Our data, when extrapolated to the US population, estimate that every 2 years between 31,000 and 168,000 susceptible pregnant women will be exposed to CMV by an infected child.

Section snippets

Subjects

Subjects were women recruited at 36 day care centers in the metropolitan areas of Richmond (18) and Norfolk, Virginia (18) between August 2005 and January 2007. The 36 day care centers enrolled 1394 children less than the age of 24 months, and of these, 912 mothers were approached at the day care center and asked to provide information about their plans for additional children. Information was provided by 696 (76%) women and of these: 81 (11.6%) stated they were pregnant or trying to become

Results

Of 70 women enrolled, 10 were lost to attrition. Reasons for attrition were the subjects were unavailable for follow-up or withdrew their child from day care. The demographic features of the women not completing the study were similar to those who completed the study (data not shown).

Table 1 lists by study location the demographic makeup and serostatus of the 60 subjects included in the data analysis. Overall, the women from both locations were similar for ethnicity, level of education, family

Comment

Among mothers with a young child in day care who were considering or planning additional children, we observed a very high pregnancy rate (38%) with conception occurring on average 10 months after enrollment. Further, among the seronegative pregnant women, approximately one half were exposed to CMV by a child shedding CMV after a probable day care–acquired infection. Although none of the seronegative pregnant women became infected during pregnancy, it is of note that 4 of 7 nonpregnant women

Acknowledgments

We are grateful for the help of Ann Marie Manganello, Debbie Bailey, Cheryl Millam, Ronzo Lee, and Al Best.

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Cite this article as: Marshall BC, Adler SP. The frequency of pregnancy and exposure to cytomegalovirus infections among women with a young child in day care. Am J Obstet Gynecol 2009;200:163.e1-163.e5.

This study was supported by a grant from the National Institutes of Health (B.C.M.).

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