{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:19:37Z","timestamp":1790518777785,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the efficacy of hyperimmunoglobulin (HIG) treatment in women with a recent primary cytomegalovirus (CMV) infection up to 14\u2009weeks' gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is an ongoing observational study conducted at the prenatal medicine departments of the University Hospitals of T\u00fcbingen, Bonn, Cologne and Erlangen, Germany, as well as at the Laboratory Prof. Gisela Enders and Colleagues in Stuttgart, Germany and the Institute for Medical Virology at the University of T\u00fcbingen, T\u00fcbingen, Germany. Enrolment criteria were the presence of confirmed recent primary CMV infection in the first trimester and a gestational age at first HIG administration of \u2264\u200914\u2009weeks. The following inclusion criteria indicated a recent primary infection: low anti\u2010immunoglobulin (Ig)\u2010G levels, low anti\u2010CMV\u2010IgG avidity in the presence of a positive CMV\u2010IgM test and no positive reactivity or just seroconversion anti\u2010gB2\u2010IgG\u2010reactivity. HIG administration was started as soon as possible within a few days after the first visit. HIG was administered intravenously at a dose of 200\u2009IU\/kg maternal body weight and repeated every 2\u2009weeks until about 18\u2009weeks' gestation. The primary outcome was maternal\u2013fetal transmission at the time of amniocentesis. Multivariate logistic regression analysis was used to determine significant covariates that could predict maternal\u2013fetal transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 149 pregnancies (153 fetuses) that completed the treatment. Median maternal age and weight were 32.0\u2009years and 65.0\u2009kg, respectively. Median gestational age at the time of first referral to one of the four centers was 9.4\u2009weeks. Median anti\u2010CMV\u2010IgG level, anti\u2010CMV\u2010IgM index and CMV\u2010IgG avidity were 5.7\u2009U\/mL, 2.5 and 22.3%, respectively. HIG treatment was started at a median gestational age of 10.6\u2009weeks and ended at a median of 17.9\u2009weeks. Within this time frame, HIG was administered on average four times in each patient. Amniocentesis was carried out at a median gestational age of 20.4\u2009weeks. In 143 (93.5%) of the 153 cases, the fetus was not infected. Maternal\u2013fetal transmission occurred in 10 cases (6.5% (95%\u2009CI, 3.2\u201311.7%)). On uni\u2010 and multivariate logistic regression analysis, the level of anti\u2010IgM index was the only factor associated significantly with maternal\u2013fetal transmission at amniocentesis. However, only four (40.0%) of the 10 cases with maternal\u2013fetal transmission had an anti\u2010IgM index above 11.4, which corresponds to the 95<jats:sup>th<\/jats:sup> centile of pregnancies without transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HIG is a treatment option to prevent maternal\u2013fetal transmission in pregnancy with a primary CMV infection. However, HIG treatment seems to be beneficial primarily in women with a recent primary infection in the first trimester or during the periconceptional period, and when it is administered at a biweekly dose of 200\u2009IU\/kg. \u00a9 2021 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23596","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T18:01:55Z","timestamp":1611597715000},"page":"560-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Outcome of pregnancies with recent primary cytomegalovirus infection in first trimester treated with hyperimmunoglobulin: observational study"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1497-5143","authenticated-orcid":false,"given":"K. O.","family":"Kagan","sequence":"first","affiliation":[{"name":"Department for Women's Health University Hospital of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Enders","sequence":"additional","affiliation":[{"name":"Laboratory Prof. Gisela Enders and Colleagues  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hoopmann","sequence":"additional","affiliation":[{"name":"Department for Women's Health University Hospital of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Geipel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine University Hospital of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Simonini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine University Hospital of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7750-6769","authenticated-orcid":false,"given":"I.","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Faschingbauer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospital of Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. O.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospital of Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Ganzenmueller","sequence":"additional","affiliation":[{"name":"Institute for Medical Virology and Epidemiology of Viral Diseases University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4991-0155","authenticated-orcid":false,"given":"K.","family":"Hamprecht","sequence":"additional","affiliation":[{"name":"Institute for Medical Virology and Epidemiology of Viral Diseases University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21991"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-017-4380-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30143-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.535"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.3009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23143"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.05.038"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5692"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1030"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310214"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz415.2500"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5757"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19164"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2014.03.006"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.09.013"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5338"},{"issue":"462","key":"e_1_2_9_19_1","first-page":"e1","article-title":"In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicenter, open\u2010label, phase II study","volume":"215","author":"Leruez\u2010Ville M","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1891\/0730-0832.39.5.293"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1023283"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1405377"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/175.3.533"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw237"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.018"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.05.005"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12281"},{"issue":"290","key":"e_1_2_9_28_1","first-page":"e1","article-title":"Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study","volume":"208","author":"Unterscheider J","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_9_29_1","first-page":"1","article-title":"No evidence of obstetrical adverse events after hyperimmune globulin application for primary cytomegalovirus infection in pregnancy: experience from a single centre","volume":"17","author":"Chiaie LD","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31868-7"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.23596","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T19:48:20Z","timestamp":1692560900000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.23596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/uog.23596"],"URL":"https:\/\/doi.org\/10.1002\/uog.23596","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]},"assertion":[{"value":"2020-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}