Seroepidemiologic study of human cytomegalovirus in pregnant women in Valiasr Hospital of Kazeroon,Fars, Iran

Background. Cytomegalovirus (CMV) is a common opportunistic infection among HIV-infected individuals, a major source of serious complications among organ-transplant recipients, and a leading cause of hearing loss, vision loss, and mental retardation among congenitally infected children. Women infected for the first time during pregnancy are especially likely to transmit CMV to their fetuses.

Objective. In this study, it was aimed to determine the rate of CMV seroprevalence in pregnant women, the prevalence of maternal CMV infection and also the incidence of congenital CMV infection in their newborns in the Kazeroon, south of Iran.

Methods. Between January 2007 and July 2007, all (n = 1472) pregnant women who attended the obstetric ward of Valiasr hospital in Kazeroon for delivery, were enrolled in this study, and according to the presence or absence of anti CMV-IgM and CMV-IgG, were classified as seropositive, seronegative and having active maternal CMV infection. Differentiation of primary and recurrent CMV infection in women with both CMV-IgM (+) and CMV-IgG (+) antibody was determined by the avidity index (AI) of anti-CMV IgG.

Results. The rate of seropositivity was found as 97.69% and the rate of seronegativity as 2.31% in pregnant women. The prevalence of active maternal CMV infection was found as 4.35% and among these pregnant women, the incidence of primary and recurrent maternal CMV infection was 34.4% and 65.6% respectively.

Conclusion. Seroprevalence rate of CMV in pregnant women is high and most infections are recurrent. Thus, it does not seem to be cost-effective to screen all pregnant women for CMV infection, as in the other countries with high seropositivity rate.     

Cytomegalovirus and rubella seroprevalence in pregnant women in Izmir/Turkey: follow-up and results of pregnancy outcome

Purpose

It is aimed to determine the Rubella and CMV prevalence in the pregnant women in Izmir and to research the effect of these infections on the course of pregnancy in the pregnant women exposed to infection during pregnancy.

Methods

The pregnant women applied to pregnancy outpatient department during 2001?C2008 have been examined with enzyme-linked fluorescent assay (VIDAS; bioMérieux) method in terms of Rubella and CMV IgM and IgG antibodies and CMV IgG avidity test.

Results

Totally 5,959 pregnant women were included in the study. The seropositivity rates for Rubella and CMV were found as 97.8 and 98.3?%, IgM positivity rates were found as 0.37 and 0.18?%, respectively. Curettage was recommended to the pregnant women in which Rubella IgM positivity was detected in the first trimester of the pregnancy. Eight of the pregnant women in which IgM was found as positive after the 20th week of pregnancy were examined and three intrauterine growth retardation, one hypospadias and three normal deliveries were seen in these pregnant women. Any congenital anomaly finding was not detected in the pregnant women with positive CMV IgM.

Conclusions

Seroprevalence values are high for Rubella and CMV in our region. It can be recommended not to check the pregnant women routinely for this purpose with the good implementation of Rubella vaccine programs.     

Antibodies to trophoblast in normal pregnant and secondary aborting women

Enzyme-linked immunosorbent assays (ELISA) with the use of chorionic villous plasma membranes prepared from first trimester and term placentae were employed to detect antibodies to trophoblast in normal primigravid women. Normal pregnant women were found to produce IgG antibodies to trophoblast. These antibodies could be eluted from first trimester placentae. This antibody response was observed in the first trimester and gradually decreased as pregnancy progressed. IgM antibody responses were observed only in the third trimester. Antibodies in some primigravid women and secondary recurrent aborters showed allotypic reactivity with individual trophoblast membranes. This finding was confirmed by immunoblotting experiments in which antibodies from some normal pregnant women were shown to recognize the same trophoblast antigens as those recognized by antibodies from secondary recurrent spontaneous aborters.     

Coverage and outcomes of antenatal tests for infections: a population based survey in the Province of Trento,Italy

Background: Rubella, syphilis, toxoplasmosis, cytomegalovirus (CMV), hepatitis B (HBV) and C (HCV), HIV, and Group B Streptococcus (GBS) infections may have very severe outcomes during pregnancy, and for this reason, monitoring of infections in pregnant women is a requirement of prenatal assistance.

Aims: To describe coverage and outcome of the screening for rubella, syphilis, toxoplasmosis, CMV, HBV, HCV, HIV, and Group B Streptococcus in pregnancy in the Autonomous Province of Trento, Northern Italy (538,600 inhabitants).

Methods: We analysed the coverage and outcome of the above-mentioned screenings among women who delivered in the hospitals of the Province of Trento between 2007 and 2014 (N?=?38,712). Screenings were grouped according to characteristics such as recommendation by national and local guidelines, scheduling of the tests, operating methods, and charge. We also estimated odds ratios (ORs) for missing screening for selected infections through multiple logistic regression.

Results: Estimated uptake of antenatal screening was 99.7% for rubella, 99.3% for syphilis, 99.7% for toxoplasmosis, 98.1% for HIV infection, 99.0% for HBV, 98.9% for HCV, 94.0% for GBS infection, and 75.4% for CMV infection. The overall prevalence of immunity was 94.1% for rubella, 24.2% for toxoplasmosis, and 64.2% for CMV. The rate of seroconversion in pregnant women was 0.02% for rubella, 0.29% for toxoplasmosis, and 0.75% for CMV. The overall prevalence of infection was 0.94% for HBV, 0.53% for HCV, 22.3% for GBS, 0.29% for syphilis, and 0.13% for HIV. We found a significant positive association for all screening tests, between lack of testing and late first medical examination in pregnancy (ORs ranging from 1.20 to 1.66 for the first medical visit in the second trimester and ORs ranging from 1.60 to 5.88 for the first medical visit in third trimester, compared to early medical visit in the first trimester). Compared to Italian citizenship, foreign citizenship of the mother was also positively associated with absence of screening (ORs ranging from 1.30 to 1.53). A significant inverse association was observed for calendar year of delivery (ORs ranging from 0.71 to 0.97, for 1 year increment). Less educated mothers and pluriparae were also at higher risks of not being tested. Analysis of the association with mother age showed different heterogeneous effects.

Conclusions: Our study indicates that the attention to screening and detecting infected cases is growing over the time. In addition, care delivered during pregnancy has a leading role in determining coverage of the examinations. Immigrant, pluriparous and less educated women need particular attention.     

Routine Screening for Rubella and CMV Antibodies During Pregnancy: Is it Justifiable?

Background

Rubella and cytomegalovirus (CMV) screening during pregnancy is routinely carried out in India. However, its value has been questioned due to the absence of clearly effective intervention.

Objectives

This retrospective study evaluates the usefulness of rubella and CMV antibody screening during pregnancy.

Materials and Methods

Serum samples received from pregnant women and children were tested for rubella- and CMV-specific IgM antibodies by capture ELISA. The data were analyzed to determine the incidence of rubella and CMV infection during pregnancy and in congenital infections.

Results

In asymptomatic pregnant females (n = 505), rubella positivity was 3.16 % and in women with bad obstetric history (BOH) (n = 220), it was 7.72 %, while CMV positivity was 5.9 % in both asymptomatic pregnant women and in women with BOH. In children (n = 200), the overall positivity for rubella- and CMV-specific IgM antibodies was 15 and 25 %, respectively. A declining trend was observed in the incidence of both rubella and CMV infections in pregnant women and in women with BOH. In children, the incidence of congenital rubella syndrome has declined, but the incidence of CMV infection has remained almost the same in 5 years.

Conclusion

The incidence of rubella has reduced over the past 5 years and can further be prevented by providing direct protection to women and school girls with rubella vaccines. Primary CMV infection in pregnancy is the main problem, and due to the unavailability of efficient and safe treatment, routine antenatal screening for rubella and CMV should be reserved for women with obstetric complications only.     

妊娠早期巨细胞病毒感染和产前诊断案例分析

目的 分析妊娠早期动态定量检测巨细胞病毒（cytomegalovirus,CMV）抗体水平的意义,为临床医师对妊娠期CMV筛查和诊断提供参考依据。 方法 随机抽取2021年1—12月在惠州市中心人民医院妇产科门诊进行常规妊娠期检查的孕妇810例为研究对象。所有孕妇均在妊娠12周内采用电化学发光法定量检测CMV的IgG和IgM,间隔1~2周复查1次。结合2次抗体定量结果判断孕妇是否感染和感染类型。对诊断为CMV感染并引产的胎儿做病理分析。 结果 810例样本中CMV感染者为801例,其中既往感染者为783例（96.7%）,CMV原发感染和复发感染各1例,原发感染率和复发感染率均约为0.1%,IgM持续阳性共16例（2.0%）;CMV未感染者9例（1.1%）。1例引产胎儿病理诊断为播散性先天性CMV感染。结论 妊娠早期动态定量检测CMV抗体可反映孕妇感染情况和感染类型,有效排除临床诊治中的干扰,避免过度医疗干预。科学规范的妊娠期CMV检测是出生缺陷防控的核心所在。     

Prevalence of birth defects and rubella infection in pregnant women in Gansu, west China. A survey

OBJECTIVE: To determine the incidence, disease types, sequence of birth defects and prevalence of IgG and IgM in rubella infection in prepregnancy and pregnancy within 3 months in Gansu, People's Republic of China, and to determine a baseline of birth defects for an intervention project on birth defects in Gansu. STUDY DESIGN: Liveborn and stillborn infants from January 1, 2001, to January 1, 2002, and 518 prepregnant and 373 pregnant women in 3 months in 4 counties, including 42 communities selected random by stratification cluster sampling for a survey on the economic and geographic features in the province in October 2001 were investigated. Every infant born in the study period was surveyed. The types of birth defects were classed by standard diagnostic codes (ICD-9). Five-milliliter blood samples were obtained from every prepregnant and pregnant women. Rubella IgG and IgM were measured by enzyme-linked immunosorbent assay. RESULTS: The overall number of birth defects in Gansu was 102 (16.35%). The incidence of birth defects by sex was 62 males (18.55%) and 40 females (13.9%). The types of birth defects were neural tube defect, 44 cases (7.07%); limb defects, 13 (2.09%); cleft lip and palate, 5 (0.8%); and Down syndrome, 3 (0.48%). Low birth weight occurred in 31 cases (4.98%). The seasonal incidence birth defects was spring, 24 cases (23.52%); summer, 31 (30.39%); autumn, 26 (25.49%); and winter, 21 (20.59%). There were significant differences between 4 counties. The death rate from birth defects was 48 cases (47.06%). The positive rates of IgM and IgG of rubella infection of prepregnant women were, respectively, 5.02% and 83.78%; in pregnant women they were, respectively, 2.41% and 86.33%. The seropositive rate of rubella infection of prepregnancy was 88.80%; that of pregnancy was 88.74%. CONCLUSION: The rate of rubella infection in prepregnant and pregnant women within 3 months in Gansu was one of the highest in the People's Republic of China. The rate of birth defects in Gansu was one of much higher than in the People's Republic of China as a whole.     

Seroprevalence of TORCH infections in women of childbearing age in Croatia

During 2005–2009, a seroepidemiological study was carried out in Croatia to define the population susceptible to common TORCH agents among pregnant and non-pregnant women of childbearing age. The IgG seroprevalence was 29.1% forT. gondii, 94.6% for rubella, 75.3% for cytomegalovirus (CMV), 78.7% for herpes simplex virus type 1 (HSV-1), and 6.8% for HSV-2. Acute toxoplasmosis and CMV infection (positive IgM antibodies with low IgG avidity) were documented in 0.25% and 0.09% women, respectively. IgM prevalence was 1.2% for both HSV-1 and HSV-2. None of the participants showed acute rubella infection. Seropositivity to T. gondii and HSV-2 varied significantly between age groups (p?=?0.001 and p?=?0.036, respectively). Women residing in rural regions showed a significantly higher seroprevalence rate for T. gondii, CMV, and HSV-1 than urban women (T. gondii: 44.0% vs. 25.4%, p?<?0.001; CMV: 85.0% vs. 73.1%, p?=?0.018; HSV-1: 86.0% vs. 76.4%, p?=?0.041).     

Live birth rate varies with gestational history and etiology in women experiencing recurrent spontaneous abortion

OBJECTIVES: The aims of this study were to assess pregnancy outcome in relation to etiologic factors of recurrent spontaneous abortion (RSA). STUDY DESIGN: The pregnancies from consecutive 216 RSA women were assessed for live birth rates (LBR) according to etiology. The LBR in 110 pregnancies from RSA women with unexplained etiology was investigated according to various therapies. An attempt to karyotype the abortuses was made. RESULTS: Excluding pregnancies ending in abortion with abnormal karyotype, the LBR in primary recurrent spontaneous aborters (68.8%) who experienced three or more abortions was significantly lower than that in primary repeated aborters (82.4%) who experienced two abortions. The LBR ranged from 50 to 100% according to the etiology. In RSA women with unexplained etiology, the LBR in those undergoing massive intravenous immunoglobulin (MIVIg) therapy (100%) was significantly higher than those with low dose aspirin (57.1%) and luteal support therapy (67.3%). CONCLUSIONS: Excluding pregnancies ending in abortion with abnormal karyotype, we found that LBR varied with abortion history and etiologic factors of RSA.     

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

Background

The increased complications to the mother and fetus during or after pregnancy and birth are often caused by a wide array of pathogenic organisms mostly belonging to the TORCH group [toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)]. These agents cause asymptomatic or mild infection in the mother while serious consequences in fetus. The present study was aimed to find significant etiological pathogens in the causation of high risk pregnancy (HRP) in South Indian population.

Material and Methods

A total of 1,158 HRP women (2010–2013) from Modern Government Maternity Hospital, Hyderabad were considered. Two milliliter of blood was obtained and the serum was analyzed for IgG and IgM antibodies against TORCH agents by ELISA.

Results

Twenty-five percent of the study group had fetal congenital malformation in the present pregnancy (Group 1; N = 291) while 75 % showed bad obstetric history (BOH) (Group 2; N = 867). Maternal age of ≤25 years, primi gravida, and consanguinity showed predisposing role for Group 1 while maternal age ≥30 years and ≥ 3 gravida were contributing risk for Group 2. The seropositvity in HRP women for toxoplasma, rubella, CMV, and HSV was 28, 84, 92, and 61 %, respectively for IgG while it was 6, 3, 4, and 3 % for IgG + IgM. Total seropositvity of toxoplasma, rubella, CMV, and HSV in Group 1 was 29, 97, 97, and 62 % while it was 36, 84, 97, and 65 % in Group 2, respectively.

Conclusion

Maternal age of ≤25 years, primi gravida, and consanguinity contributed to fetal congenital malformation in the present pregnancy while maternal age of ≥30 years and ≥ 3 gravida towards BOH. Toxoplasma is protective while rubella and CMV are the infectious agents for HRP. Among the groups, toxoplasma and rubella conferred a predisposing risk towards Group 2 and Group 1, respectively. Sixty-one percent seropositvity of HSV in relation to bad obstetric outcome is the highest prevalence reported so far in India.

Electronic supplementary material

The online version of this article (doi:10.1007/s13224-014-0615-3) contains supplementary material, which is available to authorized users.     

Congenital and maternal cytomegalovirus infections in a London population.

OBJECTIVE--To determine if women at risk of having babies infected with cytomegalovirus (CMV) can be identified antenatally. DESIGN--Prospective serological and demographic study of pregnant women and virological study of their newborn infants. SETTING--Teaching hospital in London. SUBJECTS--3315 pregnant women and 2737 of their babies. MAIN OUTCOME MEASURES--Quantitative detection of CMV IgG antibodies; qualitative detection of CMV IgM antibodies; demographic characteristics of mothers; qualitative and quantitative titration of CMV viruria in newborn. RESULTS--Congenital CMV infection was found in nine newborn babies (0.33%) two of whom had symptoms. Serological testing of the nine mothers showed four primary and five recurrent infections; both of the symptomatic children were born in the latter group. Testing for CMV specific IgM antibodies or quantitation of IgG antibodies in early pregnancy sera could not differentiate those women at risk of giving birth to babies infected or damaged by CMV from the rest of the population. Quantitation of viruria confirmed that those babies most at risk of CMV disease have the highest titres of CMV. CONCLUSIONS--(i) Since laboratory tests in pregnant women cannot reliably identify fetuses at risk of disease, screening for asymptomatic maternal infection coupled with termination of pregnancy cannot be recommended. (ii) Since 'immune' women can still give birth to babies affected by CMV, we propose that future CMV vaccines should be used to immunize children with the aim of eradicating CMV infection in preference to selective immunization of sero-susceptible females.     

Antenatal Screening for Congenital Infection with Rubella, Cytomegalovirus and Toxoplasma

Summary: The sera of 3,463 pregnant women were screened, at the first antenatal visit, for antibodies to rubella, cytomegalovirus (CMV) and Toxoplasma gondii. Rubella antibodies were detected in 97.5%, CMV antibodies in 71% and toxoplasma antibodies in 45% of women. Asymptomatic toxoplasmosis occurred during pregnancy in 3 of 609 (0.5%) and primary CMV infection in 5 of 338 (1.5%) initially seronegative women whose sera were retested at the end of their pregnancies. The observed incidence of toxoplasmosis was similar to that calculated on the basis of the age-related prevalence of antibodies found in this study. On the basis of these observations it is estimated that congenital toxoplasmosis and congenital CMV infection due to primary maternal infection each occurs in up to 2/1,000 infants in this community. Very few of these infants have obvious abnormalities at birth, but follow-up studies elsewhere have shown that many of them suffer significant long-term sequelae.     

The evaluation of expression of T-lymphocytes and NK cell surface receptors in women with threatened miscarriage

OBJECTIVES: Recent studies emphasise an important role of immunological mechanisms in pregnancy maintenance. Therefore, unravelling mechanisms regulating placentogenesis are critical to understanding the pathogenesis of recurrent spontaneous abortion. MATERIALS AND METHODS: We studied 49 women with threatened abortion and 24 healthy pregnant women. In addition, we studied 17 women with the history of recurrent spontaneous abortion and 10 healthy nonpregnant women in reproductive age with the previous successful pregnancy outcome. CD3, CD45 RO, CD4, CD8, CD16 expression on peripheral blood lymphocytes were studied using flow cytometry. RESULTS: We determined that there is significantly higher CD4 expression in pregnant recurrent aborters compared to control (p < 0.05). Pregnant recurrent spontaneous aborters, with the successful pregnancy outcome have significantly lower CD16 expression compared to those, who abort (p < 0.05). CONCLUSION: Our studies may indicate that T cell and NK cell can be involved in the pathogenesis of pregnancy loss.     

A prospective study of primary cytomegalovirus infection during pregnancy: final report

In a 7-year prospective study cytomegalovirus (CMV) was shown to infect approximately twice as many pregnant women as did rubella virus. Fetal loss occurred in 4/26 (15%) early CMV infections which was seven-fold higher than the rate found in controls (16/744; 2.2%). There was no evidence that fetal loss resulted from intrauterine transmission of virus. Fifty-eight women experienced primary CMV infection and congenital infection was found in nine (20%) of the 46 infants from whom clinical samples were obtained. Transmission of virus was found in 20%, 0% and 40% in the first, second and third trimesters respectively. All babies were normal at birth but two have so far developed definite intellectual impairment attributable to cytomegalovirus infection. The mothers of both of these cases were infected after the fetus had become legally viable. We conclude that the lessons learned from studying rubella infection during pregnancy cannot be applied to cytomegalovirus; in particular, we could find no evidence that termination of pregnancy should be offered to women with early CMV infections.     

Characteristics and serology of pregnant women with cytomegalovirus immunoglobulin G seroconversion during pregnancy in Japan

ObjectiveInvestigate the characteristics and serology of pregnant women with cytomegalovirus (CMV) immunoglobulin (Ig)G seroconversion during pregnancy to understand the risk factors associated with primary CMV infection and the occurrence of fetal congenital CMV infection.Materials and methodsWe retrospectively studied 3202 pregnant women who were CMV IgG-negative in early pregnancy and were retested for IgG in late pregnancy. Characteristics were compared between participants with and without IgG seroconversion, and serological parameters were compared between participants with and without fetal congenital CMV infection.ResultsTwenty-six participants showed CMV IgG seroconversion and fifteen showed fetal congenital CMV infection. Seroconversion rates were significantly higher in teens (5.0%) than in older women (20s: 0.8%; 30s and over: 0.6%) (p < 0.001). Titers of CMV IgM at IgG seroconversion were higher in women without (median 8.66) than with (median 6.54) congenital infection (p = 0.045). The congenital infection rate was high when IgM titers at IgG seroconversion were low (47.1% with 4.00–12.00 titers and 100% with 1.21–3.99 IgM titers) (p = 0.048).ConclusionsNulliparous pregnant teenagers have a high risk of CMV IgG seroconversion and the CMV IgM titer at IgG seroconversion may help predict the occurrence of fetal congenital CMV infection.     

Prevalence of serum anti-rubella virus antibodies among pregnant women in southern Italy

ObjectiveTo determine the prevalence of anti-rubella virus antibodies and the level of knowledge about congenital rubella syndrome (CRS) among pregnant women living in southern Italy.MethodsA seroepidemiologic study was conducted between July 1, 2006, and December 31, 2007. Five-hundred women resident in Messina were enrolled in the study; the participants were in the 4th to 39th week of pregnancy. Anti-rubella virus antibodies were assayed using a microparticle enzyme immunoassay. Demographic details, vaccination history, and participants’ knowledge of the potential risks of rubella infection during pregnancy were assessed via questionnaire.ResultsOn the basis of the questionnaire results, 70.4% of women were classed as immune to rubella virus infection; however, the prevalence of IgG anti-rubella virus antibodies measured in the participants’ serum was 85.8%. Although 55.2% of women had undergone pre-pregnancy rubella screening, only 81 participants reported that they had been vaccinated before becoming pregnant. The participants’ general knowledge about CRS was poor, as was their understanding of the importance of undergoing screening.ConclusionThe number of women at risk of rubella infection fell short of the national target set for elimination of CRS. Increased involvement and collaboration by all healthcare workers are, therefore, required to disseminate the information necessary to prevent CRS.     

Abnormal immunoglobulin subclass patterns in women with a history of recurrent miscarriage.

OBJECTIVE: To determine whether IgG subclass patterns differed between nonpregnant women, healthy pregnant women, and pregnant women with a history of recurrent miscarriage. DESIGN: Controlled clinical study. SETTING: An academic setting. PATIENT(S): Group 1 was comprised of 10 nonpregnant women, group 2 of 10 healthy pregnant women, group 3 of eight pregnant women with a history of recurrent miscarriage and whose pregnancies on this occasion went to term, and group 4 of 10 women with a history of recurrent miscarriage whose pregnancies again failed later in the first trimester. INTERVENTION(S): None of the patients received any medication. MAIN OUTCOME MEASURE(S): Serum levels of total IgG and IgG 1, 2, 3, and 4. RESULT(S): The results obtained showed that normal pregnancy was associated with a significant increase in total IgG production and an increase in IgG subclasses 1, 2, and 3. Women with a history of miscarriage, but who had a successful pregnancy on this occasion, showed a similar pattern of IgG subclasses. Women with a history of miscarriage and whose pregnancy again ended in miscarriage showed a different IgG subclass pattern. CONCLUSION(S): Pregnancies that ended in miscarriage showed a different pattern of IgG subclasses than those that continued to term. The changes seen in immunoglobulin patterns could be linked to changes in cytokine production.     

Association between recurrent spontaneous abortions and circulating IgG antibodies to sperm tails in women

The isotype and regional specificity of antisperm antibodies in the circulation of women with recurrent spontaneous abortions was examined. There was a statistically significant association (P less than 0.005) between the presence of IgG tail-directed antisperm antibodies and a history of unexplained recurrent spontaneous abortion. These antibodies were detected in 36.4% of 44 women with recurrent abortions and 14.6% of 616 female partners of infertile marriages. In contrast, no differences in IgG sperm head-directed antibodies or in IgA and IgM antisperm antibodies were observed between the two groups. Husbands of women in the miscarriage or infertile groups had similar semen evaluations. Antisperm antibodies may be a marker for defective immunosuppression in women with recurrent miscarriages. Alternatively, exposure of sperm-sensitized pregnant women to sperm may activate the maternal immune system to respond to paternal antigens present on the embryo.     

Cytomegalovirus (CMV) and rubella virus infection during pregnancy. A study of CMV and rubella virus antibodies in 2014 pregnant women and follow-up studies of infants at risk for intrauterine CMV infections

Two blood samples, one in the first and one in the third trimester, were collected from 2014 pregnant women. Serological tests for CMV and rubella antibodies were performed in the paired samples. Seroconversion by the CF test for CMV antibodies was demonstrated in 15 women. However, seroconversion also by the IF test was found in only one of these. A rise in titer during pregnancy by the CF test was found in 16 woman. None of these specimens contained specific IgM. High CMV-CF antibody titer (greater than 128) in the first serum sample was found in 28 women, but none of the sera contained specific IgM. It is concluded that no single serological test can serve at present as a screening test for the diagnosis of CMV infection during pregnancy. In children thought to be at risk contracting congenital CMV infection, no case with CNS malfunction that could be attributed to a congenital CMV infection could be demonstrated at the age of 7-8 years. One case of seroconversion in the examination for rubella antibodies was found. The infant of this mother showed no clinical signs of rubella infection.     

Cytogenetics of aborters and abortuses

783 aborters and 430 abortuses were studied in a prospective cytogenetic survey which attempted to link chromosome abnormalities and history of recurrent abortion. 425 female and 358 male spontaneous aborters and their 430 abortuses (310 were karotyped) showed 4 women and 2 men as balanced translocation carriers (3 Robertsonian and 3 reciprocal translocations) and a woman with an XXX karotype. 5 of the abortuses were successfully karotyped; 4 had inherited unbalanced translocation products, and the other had a balanced 13q14q translocation plus trisomy 18. Apparently, translocation chromosomes carried by aborters were transmitted to their abortuses. Structural chromosome abnormalities were found with higher frequency (.8%) among aborters than among the general adult population (.3%). Translocation carriers were more frequent among the aborters with histories of recurrent abortions (2.7%) as well as among aborters with a history of perinatal deaths (3.6%) than among those persons with no such histories (.6%). Data on 18 couples whose 2 or 3 successive spontaneous abortuses were karotyped are presented.