BEST INFORMATION ABOUT CONGENITAL CMV AND BIRTH DEFECTS


Cytomegalovirus, or CMV, is a very common member of the herpes family of viruses. By age 40, half of the adult population has been infected with CMV. Usually, a CMV infection is short-lived, does not produce noticeable symptoms, and afterward lies dormant in the body for life.
But what happens if a pregnant woman picks up CMV for the first time during a pregnancy, or has a recurrent infection from a previous exposure? Are there risks to the fetus? And if so, how can your healthcare provider help to minimize these risks?
In this article, we will address the birth defects associated with congenital CMV and ways to protect yourself and your growing baby. If you’d like to know more about CMV during pregnancy in general, check out our article Cytomegalovirus (CMV) Infection.
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Congenital CMV Birth Defects:  In The Womb

Not all babies born to CMV-infected mothers develop congenital CMV, and not all that do pick up CMV will experience long-term effects. However, it is essential to be aware of the risks because some of them can affect how your child will live his or her life.

What is the risk of passing CMV to my baby during pregnancy?

In general, 1 of every 150 to 200 babies in the USA is born with congenital CMV. This makes CMV the most frequent congenital viral infection. Though this seems like a large percentage of births, only 1 in 5 of these infants born with congenital CMV will experience any adverse symptoms or long-term issues.
The virus has the potential to travel through the mother’s blood and pass through the placenta, infecting the developing baby.
If you have the virus before you become pregnant:  There is a very low chance of passing it to your baby. The chance heightens if you are reinfected with a different strain of the virus (see statistic below), or if you have a reactivation of the virus during your pregnancy.
If you contract the virus (primary infection) during your pregnancy:  It is more likely to pass on CMV to your baby if you get a primary infection during the pregnancy than it is to pass it if you were previously infected. If you have a primary CMV infection during pregnancy, there is approximately a 40% chance of passing the virus to your baby.
The risk of transmission from mother to baby is highest if she gets a primary CMV infection in the third trimester (40-70%) and is lowest if the primary infection begins in the first or second trimesters (30-40%).

Can congenital CMV harm my developing baby?

CMV can pass to your baby at any time during your pregnancy, and any congenital CMV symptoms that are present after birth develop in the womb. So in a sense, yes, CMV can harm your developing baby.
However, the risk of death to a fetus from contracting CMV is extremely small. Doctors have witness seizures in a fetus after contracting congenital CMV, but most of these babies are able to survive and thrive well past birth.
There are quite a few abnormal ultrasound readings that may indicate a congenital CMV infection, including but not limited to:
  • Organomegaly (abnormal organ enlargement) – spleen, liver, and others
  • Abnormal dilation of lateral brain ventricles, the ureter, and/or the renal pelvis
  • Intracranial calcifications
  • Microcephaly
  • Placental thickening
  • Fetal hydrops
  • Ascites
  • Hepatic, intestinal, or periventricular echodensities
One or more of these may indicate congenital CMV; however, many of these abnormalities are linked to a plethora of other diseases or syndromes.

Congenital CMV Birth Defects:  Types

Which birth defects are associated with congenital CMV? The main ways that congenital CMV can affect an infant immediately or over time are:
1.     Hearing loss
2.     Mental disability
3.     Seizures
4.     Vision loss
5.     Decreased muscle strength (including cerebral palsy)
6.     Decreased coordination
7.     Microcephaly
However, it is important to remember that the majority of infants born with CMV do not suffer any long-term effects or ailments.

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