{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:48:17Z","timestamp":1790192897006,"version":"4.1.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Dev Pathol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Congenital cytomegalovirus (cCMV) is a common congenital viral infection. Testing for cCMV usually begins with assessing maternal CMV serology, specifically IgM and IgG antibodies. A negative maternal CMV IgM suggests a low risk of recent maternal CMV infection, thereby suggesting a low risk of cCMV in the fetus. Consequently, cCMV is often ruled out when maternal CMV IgM is negative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In our perinatal autopsy and placental pathology database, we identified 5 cases of cCMV despite negative maternal CMV IgM results in the second trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In all 5 cases, fetal abnormalities were first detected by ultrasound in the second trimester, prompting maternal CMV testing. Since second trimester maternal CMV IgM was negative in all cases, cCMV was considered unlikely, thus precluding further prenatal CMV testing in 4 of these cases. The diagnosis of cCMV was subsequently made through placental and\/or autopsy examinations. Following this diagnosis, retrospective CMV serology and IgG avidity testing was performed on stored frozen first-trimester maternal blood samples in 3 cases. Among these, the first-trimester samples in 2 cases were IgG+, IgM+, and exhibited low IgG avidity, suggesting a primary maternal CMV infection around the time of conception. In the third case, both first and second-trimester maternal blood samples were IgG+, IgM\u2212, and showed high IgG avidity, suggesting a non-primary maternal CMV infection (i.e., reactivation or reinfection of CMV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A negative maternal CMV IgM in the second trimester cannot exclude cCMV infection. While CMV IgG avidity testing and analysis of stored frozen first-trimester maternal blood samples provide valuable insights, they have limitations. CMV PCR performed on amniotic fluid is a useful prenatal diagnostic tool. For cases of unexplained fetal abnormalities or death, autopsy and placental examination are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10935266241253477","type":"journal-article","created":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T01:05:02Z","timestamp":1726275902000},"page":"530-544","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Maternal Cytomegalovirus (CMV) Serology: The Diagnostic Limitations of CMV IgM and IgG Avidity in Detecting Congenital CMV Infection"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5260-5798","authenticated-orcid":false,"given":"Elaine S.","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"},{"name":"Alberta Children\u2019s Hospital, Calgary, AB, Canada"},{"name":"Alberta Precision Laboratories, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Suchet","sequence":"additional","affiliation":[{"name":"EFW Radiology, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Somerset","sequence":"additional","affiliation":[{"name":"EFW Radiology, Calgary, AB, Canada"},{"name":"Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"de Koning","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"},{"name":"Alberta Children\u2019s Hospital, Calgary, AB, Canada"},{"name":"Alberta Precision Laboratories, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rati","family":"Chadha","sequence":"additional","affiliation":[{"name":"EFW Radiology, Calgary, AB, Canada"},{"name":"Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Soliman","sequence":"additional","affiliation":[{"name":"EFW Radiology, Calgary, AB, Canada"},{"name":"Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Kuret","sequence":"additional","affiliation":[{"name":"EFW Radiology, Calgary, AB, Canada"},{"name":"Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"},{"name":"Alberta Children\u2019s Hospital, Calgary, AB, Canada"},{"name":"Alberta Precision Laboratories, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lauzon","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ann","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"},{"name":"Alberta Precision Laboratories, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Yuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada"},{"name":"Alberta Precision Laboratories, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"bibr1-10935266241253477","unstructured":"Centers for Disease Control and Prevention. Healthcare Professionals: Cytomegalovirus (CMV) Resources. Centers for Disease Control and Prevention. May 31, 2019, https:\/\/www.cdc.gov\/cmv\/resources\/healthcare-professionals.html. 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