{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:57:31Z","timestamp":1792040251350,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"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":["BJOG"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the cost\u2010effectiveness of prenatal detection of congenital cytomegalovirus (cCMV) following maternal primary infection in the first trimester within standard pregnancy follow\u2010up or involving population\u2010based screening (serological testing at 7 and 12 weeks of gestation), with or without secondary prevention (valaciclovir) in maternal CMV primary infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cost\u2010effectiveness study from the perspective of the French national health insurance system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Cost\u2010effectiveness based on previously published probability estimates and associated plausible ranges hypothetical population of 1,000,000 pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Hypothetical population of 1,000,000 pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cost\u2010effectiveness of detecting fetal cCMV in terms of the total direct medical costs involved and associated expected outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Detection rates and clinical outcomes at birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Moving to a population\u2010based approach for targeting fetal CMV infections would generate high monetary and organizational costs while increasing detection rates from 15% to 94%. This resource allocation would help implementing horizontal equity according to which individuals with similar medical needs should be treated equally. Secondary prevention with valaciclovir had a significant effect on maternal\u2010fetal CMV transmission and clinical outcomes in newborns, with a 58% decrease of severely infected newborns for a 3.5% additional total costs. Accounting for women decision\u2010making (amniocentesis uptake and termination of pregnancy in severe cases) did not impact the cost\u2010effectiveness results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings could fuel thinking on the opportunity of developing clinical guidelines to rule identification of cCMV infection and administration of in\u2010utero treatment. These findings could fuel the development of clinical guidelines on the identification of congenital CMV infection and the administration of treatment in utero.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>CMV serological screening followed by valaciclovir prevention may prevent 58% to 71% of severe cCMV cases for 38 \u20ac per pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16966","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T18:32:51Z","timestamp":1634322771000},"page":"301-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Leaning towards <i>Cytomegalovirus<\/i> serological screening in pregnancy to prevent congenital infection: a cost\u2010effectiveness perspective"],"prefix":"10.1111","volume":"129","author":[{"given":"V","family":"Seror","sequence":"first","affiliation":[{"name":"Aix Marseille Univ IRD AP\u2010HM 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