Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). Targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; also, congenital CMV (cCMV) may manifest with subtle signs other than SNHL. Therefore, the inclusion of additional criteria for cCMV screening appears clinically valuable. Starting January 2021, we have implemented expanded targeted cCMV screening at our center, with testing in case of maternal CMV infection during pregnancy, inadequate antenatal care, maternal HIV infection or immunosuppression, birthweight and/or head circumference < 10th centile, failed hearing screen, and prematurity. During the first three years of use of this program (2021–2023), 940 (12.3%) of 7651 live-born infants were tested. The most common indication was birthweight < 10th centile (n = 633, 67.3%). Eleven neonates were diagnosed as congenitally infected, for a prevalence of 1.17% (95%CI 0.48–1.86) on tested neonates and of 0.14% (95%CI 0.06–0.23) on live-born infants. None of the cCMV-infected newborns had a failed hearing screen as a testing indication. Implementation of an expanded cCMV screening program appears feasible and of clinical value.
Toxoplasmosis (TG) is a zoonotic disease that, if contracted during pregnancy, can lead to fetal infection with severe complications. Currently, the only way to prevent maternal infection during pregnancy is to adopt hygiene practices. Our study aimed to evaluate pregnant women’s awareness of TG infection, their knowledge of TG-specific preventive hygiene measures, and factors linked to inadequate knowledge as potential targets for intervention. A prospective survey study was conducted at a university hospital between May and November 2023. A self-administered questionnaire was given to pregnant women. Out of 402 participants, 95.3% were aware that TG could be a potential issue in pregnancy. However, only 22.5% of them were able to identify all four correct hygiene behaviors to prevent TG infection acquisition during gestation. Women with a higher level of education, of European origin, and who had heard of other potentially serious conditions in pregnancy were more likely to have an appropriate level of knowledge about TG. Healthcare professionals and mass media, when employed as sources of information before conception, played a positive role in enhancing pregnant women’s awareness of TG. In conclusion, while pregnant women showed high levels of awareness of TG infection, their knowledge of preventive measures was limited, with only less than one-fourth with appropriate knowledge. This highlights the need for innovative strategies, possibly face-to-face interactions, digital tools, and public health campaigns, to improve the ability of healthcare professionals to deliver accurate and accessible information to reduce the risk of infection acquisition during gestation.
20 November 2023 in European Journal of Obstetrics & Gynecology and Reproductive Biology
Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). A targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; also, congenital CMV (cCMV) may manifest with subtle signs other than SNHL. Therefore, inclusion of additional criteria for cCMV screening appears clinically valuable. Starting January 2021, we have implemented an expanded targeted cCMV screening at our center, with testing in case of maternal CMV infection during pregnancy, inadequate antenatal care, maternal HIV infection or immunosuppression, birthweight and/or head circumference.