Maternal immunity and prevention of congenital cytomegalovirus infection

JAMA. 2003 Feb 26;289(8):1008-11. doi: 10.1001/jama.289.8.1008.


Context: Vaccine development to prevent congenital cytomegalovirus (CMV) infection has been impeded by the uncertainty over whether maternal immunity protects the fetus.

Objective: To determine whether the presence of maternal antibodies to CMV significantly reduces the risk of congenital CMV infection in future pregnancies.

Design, setting, and participants: Cohort study of 3461 multiparous women from a population with a high rate of congenital CMV infection who delivered newborns screened for congenital CMV infection between 1993 and 1998, and whose cord serum specimen from a previous delivery could be retrieved and tested for antibody to CMV.

Main outcome measure: Congenital CMV infection according to maternal immune status, age, race, parity, and socioeconomic status.

Results: Of 604 newborns born to initially seronegative mothers, congenital CMV infection occurred in 18 (3.0%). In contrast, of 2857 newborns born to immune mothers, congenital CMV infection occurred in 29 (1.0%) Two factors, preconception maternal immunity (adjusted risk ratio, 0.31; 95% confidence interval, 0.17-0.58) and maternal age of 25 years or older (adjusted risk ratio, 0.19; 95% confidence interval, 0.07-0.49), were highly protective against congenital CMV infection. No other factors were associated with a reduction in the risk of congenital CMV infection.

Conclusion: Naturally acquired immunity results in a 69% reduction in the risk of congenital CMV infection in future pregnancies.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antibodies, Viral / blood
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / congenital*
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / prevention & control
  • Female
  • Fetal Blood / virology
  • Humans
  • Immunity, Innate*
  • Immunity, Maternally-Acquired*
  • Immunoglobulin G / blood
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology*
  • Pregnancy Complications, Infectious / prevention & control


  • Antibodies, Viral
  • Immunoglobulin G