Journal of Virological Methods 119 (2004) 31–35 Use of serial maternal urine cytomegalovirus PCR to detect primary CMV infection in seronegative pregnant women Milind Khare a,∗ , Mike Sharland a , Isaac Manyonda b , Phil Rice c , J. Martin Bland d , Paul Griffiths e a Paediatric Infectious Diseases Unit, St. George’s Hospital, London, UK b Department of Obstetrics and Gynaecology, St. George’s Hospital, London, UK c Department of Virology, St. George’s Hospital, London, UK d Department of Health Sciences, Seebohm Rowntree Building Area 2, University of York, Heslington York YO10 5DD, UK e Department of Virology, Royal Free and University College Medical School, London, UK Received 28 November 2003; received in revised form 20 February 2004; accepted 24 February 2004 Abstract The aim of the study was to determine if serial maternal urine polymerase chain reaction (PCR) tests can detect primary CMV infection during pregnancy. This was a prospective study conducted from 1 January 1999 to 31 December 1999 in an antenatal clinic setting of a teaching hospital. The study group included women who were CMV IgG negative and aged <30 years or had a pre-school child. They were invited to self-collect urine samples monthly and send them to the laboratory by post. Cord bloods were tested for CMV IgG to detect seroconversion. An anxiety questionnaire was sent to all study participants. At first attendance, 1549 (42%) women were CMV IgG negative. Of the 696 eligible women, 609 (88%) participated in the urine PCR study. PCR was performed on 2263 urine samples (median of 4/pregnancy). Primary CMV infection was identified in one woman by urine PCR at 36 weeks (baby CMV negative). Cord blood samples were available from 152/609 infants (25%). Seroconversion was noted in only one woman. Replies to the questionnaire were received from 264/609 women (43%): 214 (81%) had little or no anxiety, and 220 (83%) felt reassured by their study participation. Serial urine PCR is a feasible method of detecting primary maternal CMV infection during pregnancy which has potential for evaluation in further studies. © 2004 Elsevier B.V. All rights reserved. Keywords: Cytomegalovirus; Pregnancy; Urine PCR 1. Introduction CMV infection is the most common congenital infection (Stagno et al., 1977) with a reported incidence of 0.5–2% (Peckham, 1991). About 7% of infants are symptomatic at birth, with high rates of subsequent neurological handicap in this group (Boppana et al., 1992). Sensorineural hearing loss is reported in 40% of symptomatic and 7% of asymp- tomatic infants with congenital CMV (Dahle et al., 2000; Stagno et al., 1986; Yow et al., 1988). Symptomatic children ∗ Corresponding author. Present address: Department of Clinical Mi- crobiology, Leicester Royal Infirmary, Level 5, Sandringham Building, Aylestone Street, Leicester LE1 5WW, UK. Tel.: +44-116-2586526; fax: +44-116-2551949. E-mail address: mkhare2@hotmail.com (M. Khare). who develop hearing loss have higher urine CMV titres dur- ing infancy than those with normal hearing (Rivera et al., 2002). In the majority of cases, primary maternal CMV infection is either asymptomatic or associated with a minor febrile ill- ness (Griffiths and Baboonian, 1984; Peckham et al., 1983; Stagno et al., 1986; Yow et al., 1988). Screening by se- rial CMV IgG or IgM antibodies has been conducted in large studies (Ahlfors, 1982; Grant et al., 1981; Griffiths and Baboonian, 1984; Kumar et al., 1984; Stagno et al., 1986; Stern and Tucker, 1973; Yow et al., 1988) but requires fre- quent blood tests during pregnancy, which are difficult to obtain with contemporary obstetric practice where patients no longer attend hospital as frequently as in the past. The aim of this study was therefore to investigate the possibility 0166-0934/$ – see front matter © 2004 Elsevier B.V. All rights reserved. doi:10.1016/j.jviromet.2004.02.013