Cytomegalovirus seroprevalence and associated factors among pregnant women at Kawempe National Referral Hospital

Abstract

Background: In low and middle-income countries, maternal primary CMV infection results in 30-40% vertical transmission rate and could be a contributing factor to the high burden of adverse perinatal outcomes like abortion and microcephaly. The magnitude of maternal CMV infection and its sequelae are not well studied in Uganda and most of sub Saharan Africa. This study therefore investigated the sero-prevalence and factors associated with CMV infection among pregnant women at Kawempe National Referral Hospital. Methods: A cross sectional study was conducted between September 2020 and January 2021 among 637 pregnant women admitted to the labour ward at Kawempe National Referral Hospital. Data on socio-demographic, medical, obstetrics and socio-economic characteristics was collected using REDCap. Blood samples from the study participants were drawn and analysed for the presence of IgG and IgM for CMV. CMV screening for presence of serum IgM (recent exposure) and IgG (previous exposure) was done using ELISA based quantitative assays. Data analysis was done using STATA version 15. Bivariate analysis and logistic regression was performed to determine the factors associated with CMV infection. Results: The sero-prevalence of CMV (IgG) was universal (100%) and that of CMV (IgM) was 5.8%. Wealth status was significantly associated with CMV infection (IgM positivity) with the less poor more likely to be infected compared to the least poor [aOR 4.02(1.21-13.29)]. Conclusion: The sero prevalence of CMV among pregnant women in Uganda was extremely high. Women with the less poor status were more likely to be recently infected with CMV compared to those with the least poor status. Recommendation: Based on the very high burden of CMV exposure among pregnant women in Uganda, further research to determine the extent of vertical transmission and neurological sequel among exposed infants is recommended.