{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:44:05Z","timestamp":1791492245196,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Congenital cytomegalovirus (CMV) infection, a leading cause of sensorineural hearing loss and neurological impairment, is typically diagnosed by second\u2010trimester amniocentesis, delaying clinical decision\u2010making. This study aimed to assess the predictive value of maximum trophoblast thickness (MTT) measured by first\u2010trimester three\u2010dimensional (3D) ultrasound, in combination with maternal biomarkers, for the early prediction of CMV vertical transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study of pregnant women, not previously seropositive for CMV, who were referred to Necker\u2013Enfants malades Hospital between October 2019 and May 2024 for maternal primary infection (MPI) with CMV in early pregnancy. Multiple pregnancies and fetuses with genetic anomaly were excluded. MTT measurement was performed using 3D multiplanar ultrasound between 11\u2009+\u20090 and 14\u2009+\u20096\u2009weeks' gestation by two independent observers. Interobserver agreement for MTT measurement was assessed using the intraclass correlation coefficient (ICC). We recorded maternal characteristics, including first\u2010trimester maternal biomarkers (pregnancy\u2010associated plasma protein\u2010A, free \u03b2\u2010human chorionic gonadotropin and placental growth factor) and CMV polymerase chain reaction (PCR) status in the maternal blood and urine. Vertical transmission was confirmed by CMV\u2010PCR in chorionic villi (CV) and\/or amniotic fluid (AF). The\u00a0predictive value of MTT, alone and in combination with relevant covariables, was assessed using logistic regression models and receiver\u2010operating\u2010characteristics (ROC)\u2010curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 127 pregnant women with a median gestational age (GA) at CMV\u2010MPI of 2.0 (interquartile range, \u22122.5 to 7.0)\u2009weeks were included, of whom 120 (94.5%) received valacyclovir for secondary prevention. CMV\u2010PCR was positive in 7.1% of CV samples (median GA at sampling, 13.7\u2009weeks) and 9.4% of AF samples (median GA at sampling, 17.4\u2009weeks). MTT was significantly higher in cases with a positive CMV\u2010PCR result in AF compared to those with a negative result (median, 21.3\u2009mm\n                      <jats:italic>vs<\/jats:italic>\n                      17.1\u2009mm;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017). The ICC for MTT measurement was 0.827 (95%\u2009CI, 0.763\u20130.875), indicating good interobserver reproducibility. ROC\u2010curve analysis identified 19.0\u2009mm as the optimal MTT threshold, yielding a sensitivity of 83.33% (95%\u2009CI, 62.25\u2013100%) for predicting vertical transmission. When combined with CMV\u2010PCR positivity in the maternal blood in the first trimester and delayed valacyclovir initiation beyond 10\u2009weeks, the predictive model achieved an area under the ROC curve of 0.94 (95%\u2009CI, 0.87\u20130.99) for CMV\u2010PCR positivity in AF, with a sensitivity of 80.00% (95%\u2009CI, 44.39\u201397.48%), specificity of 93.26% (95%\u2009CI, 85.90\u201397.49%), positive predictive value of 57.14% (95%\u2009CI, 36.71\u201375.40%) and negative predictive value of 97.65% (95%\u2009CI, 92.31\u201399.31%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased MTT measured by 3D ultrasound in the first trimester is associated with CMV vertical transmission and may serve as an early non\u2010invasive marker. Combining MTT with CMV\u2010PCR status in the maternal blood and timing at initiation of treatment improves predictive accuracy and could guide early counseling and targeted invasive testing. \u00a9 2025 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70019","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T07:39:31Z","timestamp":1759736371000},"page":"598-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non\u2010invasive prenatal diagnosis of congenital cytomegalovirus infection using maximum trophoblast thickness and biomarkers in maternal blood and urine in first trimester"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-4085","authenticated-orcid":false,"given":"N.","family":"Bourgon","sequence":"first","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"INSERM UMR\u20101163, Genetics and Development of Cortex, Imagine Institut Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-6887","authenticated-orcid":false,"given":"C.","family":"Chatzakis","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Jacquier","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3631-184X","authenticated-orcid":false,"given":"J.","family":"Fourgeaud","sequence":"additional","affiliation":[{"name":"Virology Laboratory Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Guilleminot","sequence":"additional","affiliation":[{"name":"Virology Laboratory Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Bussieres","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. J.","family":"Salomon","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Leruez\u2010Ville","sequence":"additional","affiliation":[{"name":"Virology Laboratory Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5675-267X","authenticated-orcid":false,"given":"Y.","family":"Ville","sequence":"additional","affiliation":[{"name":"Obstetrics \u2010 Fetal Medicine Surgery and Imaging Unit, Necker\u2010Enfants malades Hospital, GHU Paris Centre AP\u2010HP  Paris France"},{"name":"EA FOETUS 73\u201028, Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.07.022"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5025"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23608"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100892"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1128"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26106"},{"issue":"4","key":"e_1_2_7_8_1","first-page":"221","article-title":"The French National Committee on Obstetrical and Fetal Ultrasound Guidelines 2022 (CNEOF)","volume":"51","author":"Conf\u00e9rence Nationale de l'Echographie Obst\u00e9tricale et F\u0153tale","year":"2023","journal-title":"Gynecol Obstet Fert Senol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5331"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1923"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12386"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11136"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2012.31.2.213"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/507634"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.018"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5756"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21936"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9051258"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2005.02.009"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00430-019-00613-w"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.909646"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix337"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T18:57:02Z","timestamp":1763492222000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.70019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/uog.70019"],"URL":"https:\/\/doi.org\/10.1002\/uog.70019","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,6]]},"assertion":[{"value":"2025-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}