Please cite this article in press as: Vauloup-Fellous C, et al. Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy?. Results of a 3-year prospective study in a French hospital. J Clin Virol (2009), doi:10.1016/j.jcv.2009.09.003 ARTICLE IN PRESS G Model JCV-1809; No. of Pages 5 Journal of Clinical Virology xxx (2009) xxx–xxx Contents lists available at ScienceDirect Journal of Clinical Virology journal homepage: www.elsevier.com/locate/jcv Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital Christelle Vauloup-Fellous a,b,∗,1 , Olivier Picone c,d,1 , Anne-Gaëlle Cordier c , Isabelle Parent-du-Châtelet e , Marie-Victoire Senat c,f , René Frydman c,d , Liliane Grangeot-Keros a,b a INSERM U764, Université Paris-Sud, Clamart, F-92140, France b AP-HP, Service de Microbiologie-Immunologie Biologique, Hôpital Antoine Béclère, Clamart, F-92140, France c AP-HP, Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart, F-92140, France d Université Paris-Sud, UMR-S0782, Clamart, F-92140, France e Institut National de Veille Sanitaire, St. Maurice, F-94415, France f Service d’Epidémiologie, Démographie et Sciences Sociales, INSERM U822, Le Kremlin-Bicêtre, F-94276, France article info Article history: Received 13 March 2009 Accepted 13 August 2009 Keywords: Cytomegalovirus Pregnancy Congenital infection Screening and counseling Seroconversion abstract Background: Cytomegalovirus (CMV) is the most frequent cause of congenital viral infection in developed countries. Objectives: The objective of this study was to evaluate the impact of our prenatal CMV infection screening and counseling policy. Study design: Since 2005, all pregnant women in our obstetric center have been informed about CMV infection, and if they agree, given a serological test at around 12 weeks of gestation (WG). If this first test is negative, the women and their partners are given hygiene counseling on how to prevent CMV infection, and a second test is performed at around 36 WG. Results: Among the 5312 women who had an unknown immune status, or were known to be seronegative when they had their first visit to our center for their current pregnancy, 97.4% agreed to CMV screening. Primary infection was detected in 11 women between 0 and 12 WG (0.42%), and seroconversion was diagnosed in five women between 12 and 36 WG (0.19%). Conclusions: These results suggest that if clear information is given on CMV infection during pregnancy, the rate of seroconversion is lower following counseling than before counseling. © 2009 Published by Elsevier B.V. 1. Background Cytomegalovirus (CMV) is the most frequent cause of congeni- tal viral infection, with an incidence of 0.5–1.0% of all live births in developed countries, and is the leading infectious cause of hear- ing loss and developmental delay. 1,2 It is estimated that 5–10% of infected newborns are symptomatic at birth, and that among asymptomatic newborns 10–15% will eventually show some devel- opmental disorder(s), mainly sensorineural hearing loss. 1 Although primary maternal infection seems to carry a higher risk for trans- mission and leads to greater severity of fetal infection, congenital infection and disability can also occur following secondary mater- nal infection (reactivation of infection or reinfection). 3–7 ∗ Corresponding author at: INSERM U764, Université Paris-Sud, Clamart, F-92140, France. Tel.: +33 1 45 37 42 98; fax: +33 1 46 32 67 96. E-mail address: christelle.vauloup@abc.aphp.fr (C. Vauloup-Fellous). 1 These authors contributed equally to this work. In France, primary CMV infection during pregnancy is quite fre- quent (estimated 0.6–1.4% 8,9 ), and whether or not pregnant women should routinely be tested for CMV has been debated. Currently, systematic screening for CMV infection is not recommended in our country, mainly because: (1) neither maternal treatment nor coun- seling programs have yet proved to be effective, (2) epidemiological data are incomplete, particularly concerning the rate of secondary maternal infection and its consequences, (3) establishing the prog- nosis of congenital infection is difficult, and (4) it has been thought that the possible adverse effects of screening (anxiety, early elective abortion, abusive use of amniocentesis, etc.) could be more frequent than disorders related to congenital CMV infection. 10 However, this same report also recommends that pregnant women should be given hygiene information. 10 As in other countries, 11,12 and despite its frequency, our experience is that few women have heard of CMV infection, and even fewer are aware of how it can be pre- vented. Because of the high number of neonates infected, and the public health burden of congenital CMV disease, the development of prevention programs for CMV infection is encouraged by the 1386-6532/$ – see front matter © 2009 Published by Elsevier B.V. doi:10.1016/j.jcv.2009.09.003