Rare detection of cytomegalovirus in severe fetal malformations in China.
BACKGROUND
Cytomegalovirus (CMV) is a significant cause of fetal abnormalities in developed world. Whether this could be applied in developing world remains unknown.


OBJECTIVES
To investigate CMV infection in severe fetal malformations in China.


STUDY DESIGN
During 2007-2014, 436 fetuses (237 males) with severe malformations and terminated pregnancy at median gestational age of 26(+1) weeks were enrolled. CMV DNA was detected in fetal kidneys and other tissues by real-time PCR, and CMV IgG and IgM were measured by ELISA.


RESULTS
CMV DNA was positive in kidneys and other tissues of seven (1.60%) fetuses. Hematoxylin-eosin staining showed intranuclear and intracytoplasmic inclusion bodies in kidneys of three fetuses, which was also positive for CMV antigens in immunohistochemistry. CMV DNA was found in 5 (6.1%) of 82 fetuses with central nervous system anomalies, 1 (11.1%) of 9 fetuses with abdominal anomalies, 1 (0.59%) of 168 fetuses with multiple congenital malformations, and none of fetuses with other anomalies (177). Of 293 pregnant women with plasma available, 279 (95.2%) were CMV IgG positive only and 6 (2.1%) were CMV IgG and IgM positive. Of 5 mothers with infected fetuses 1 (20%) was CMV IgG and IgM positive, while 5 (1.7%) of 288 mothers with uninfected fetuses were positive respectively (P=0.099).


CONCLUSIONS
Congenital CMV infection in fetuses with severe congenital malformations is rare, indicating no close association between CMV infection and severe fetal malformations in China. Maternal screening for CMV may have minimal value in identifying fetal malformations in developing world.
['Lin|Xiaoqian|X|', 'Wang|Jingmei|J|', 'Wang|Zhiqun|Z|', 'Ru|Tong|T|', 'Dai|Yimin|Y|', 'Li|Jie|J|', 'Zhu|Xiangyu|X|', 'Liu|Jingli|J|', 'Ye|Xiaodong|X|', 'Zhu|Bin|B|', 'Zhou|Yi-Hua|YH|', 'Hu|Yali|Y|']
D000328:Adult D000914:Antibodies, Viral D002681:China D000013:Congenital Abnormalities D003587:Cytomegalovirus D003586:Cytomegalovirus Infections D004279:DNA, Viral D004797:Enzyme-Linked Immunosorbent Assay D005260:Female D005315:Fetal Diseases D006801:Humans D007074:Immunoglobulin G D007075:Immunoglobulin M D008297:Male D008875:Middle Aged D016133:Polymerase Chain Reaction D011247:Pregnancy D011251:Pregnancy Complications, Infectious D055815:Young Adult
Cytomegalovirus Severe fetal malformations Congenital infection