{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:15:50Z","timestamp":1789992950432,"version":"4.0.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000031","name":"Institute of Human Development, Child and Youth Health","doi-asserted-by":"publisher","award":["386200"],"award-info":[{"award-number":["386200"]}],"id":[{"id":"10.13039\/501100000031","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Maternal Cytomegalovirus (CMV) infection in the first trimester (T1) of pregnancy is a public health concern, as it increases the risk of severe neurodevelopmental outcomes associated with congenital infection compared to infections occurring later during pregnancy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To determine CMV seroprevalence in T1 of pregnancy, its trend, risk factors and the incidence rate of primary infection during pregnancy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using the biobank of the prospective cohort \u201cGrossesse en Sant\u00e9 de Qu\u00e9bec\u201d collected between April 2005 and March 2010 at the Qu\u00e9bec-Laval Hospital, Qu\u00e9bec, Canada, maternal CMV serology was determined using Abbott Architect Chemiluminescence microparticle immunoassays for immunoglobulin G(IgG), immunoglobulin M(IgM) titration and IgG avidity testing. Changepoint detection analysis was used to assess temporal trends. Risk factors associated with seropositivity were determined by multivariable logistic regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>CMV seroprevalence in T1 of pregnancy was 23.4% (965\/4111, 95% CI, 22.1\u201324.7%). The incidence rate for CMV primary infection during pregnancy was 1.8 (95% CI, 1.2\u20132.6) per 100 person-years. No changepoint was identified in the maternal CMV-seroprevalence trend. Multivariable analyses showed that T1 maternal CMV seropositivity was associated with having one child OR 1.3 (95% CI, 1.10\u20131.73) or two or more children OR 1.5 (95%CI, 1.1\u20132.1), ethnicity other than Caucasian OR 2.1 (95% CI, 1.1\u20133.8) and country of birth other than Canada and the USA OR 2.8 (95% CI, 1.5\u20134.9).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this cohort, maternal seroprevalence in T1 of pregnancy and seroconversion rate were low. This information and identified risk factors could help guide the development and implementation of preventive actions and evidence-based health policies to prevent CMV infection during pregnancy.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0252309","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T17:33:22Z","timestamp":1624642402000},"page":"e0252309","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Frequency, timing and risk factors for primary maternal cytomegalovirus infection during pregnancy in Quebec"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9657-3791","authenticated-orcid":true,"given":"Safari Joseph","family":"Balegamire","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Renaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beno\u00eet","family":"M\u00e2sse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Zinszer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren","family":"Gantt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Giguere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Forest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Boucoiran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"issue":"7","key":"pone.0252309.ref001","first-page":"16","article-title":"Congenital cytomegalovirus: Impact on child health","volume":"35","author":"MR Schleiss","year":"2018","journal-title":"Contemporary pediatrics"},{"issue":"1","key":"pone.0252309.ref002","first-page":"1","article-title":"Cytomegalovirus infection in pregnancy: review of the literature","volume":"5","author":"S Bonalumi","year":"2011","journal-title":"Journal of prenatal medicine"},{"issue":"Supplement_7","key":"pone.0252309.ref003","doi-asserted-by":"crossref","first-page":"S745","DOI":"10.1093\/clinids\/12.Supplement_7.S745","article-title":"Congenital and perinatal cytomegalovirus infections","volume":"12","author":"CA Alford","year":"1990","journal-title":"Reviews of infectious diseases"},{"issue":"4","key":"pone.0252309.ref004","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/rmv.535","article-title":"Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection","volume":"17","author":"A Kenneson","year":"2007","journal-title":"Reviews in medical virology"},{"issue":"1","key":"pone.0252309.ref005","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1186\/s12889-016-3772-8","article-title":"Sociodemographic factors associated with IgG and IgM seroprevalence for human cytomegalovirus infection in adult populations of Pakistan: a seroprevalence survey","volume":"16","author":"S Ibrahim","year":"2016","journal-title":"BMC public health"},{"key":"pone.0252309.ref006","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ijid.2013.12.010","article-title":"Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries","volume":"22","author":"TM Lanzieri","year":"2014","journal-title":"International Journal of Infectious Diseases"},{"issue":"3","key":"pone.0252309.ref007","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00430-015-0399-9","article-title":"Controversies in the natural history of congenital human cytomegalovirus infection: the paradox of infection and disease in offspring of women with immunity prior to pregnancy","volume":"204","author":"W Britt","year":"2015","journal-title":"Medical microbiology and immunology"},{"issue":"2","key":"pone.0252309.ref008","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jcv.2005.09.015","article-title":"Congenital cytomegalovirus infection following first trimester maternal infection: symptoms at birth and outcome","volume":"35","author":"RF Pass","year":"2006","journal-title":"Journal of clinical virology"},{"key":"pone.0252309.ref009","article-title":"Cytomegalovirus infection during pregnancy: State of the science","author":"M Leruez-Ville","year":"2020","journal-title":"American journal of obstetrics and gynecology"},{"issue":"4","key":"pone.0252309.ref010","first-page":"45","article-title":"Primary human cytomegalovirus (HCMV) infection in pregnancy","volume":"114","author":"H Buxmann","year":"2017","journal-title":"Deutsches \u00c4rzteblatt International"},{"issue":"3","key":"pone.0252309.ref011","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/1471-0528.13050","article-title":"Screening for pre-eclampsia early in pregnancy: performance of a multivariable model combining clinical characteristics and biochemical markers","volume":"122","author":"Y Giguere","year":"2015","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"issue":"2","key":"pone.0252309.ref012","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S1701-2163(15)30331-5","article-title":"Mid-trimester maternal serum AFP and hCG as markers of preterm and term adverse pregnancy outcomes","volume":"37","author":"S Tancr\u00e8de","year":"2015","journal-title":"Journal of Obstetrics and Gynaecology Canada"},{"issue":"3","key":"pone.0252309.ref013","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.diagmicrobio.2018.12.017","article-title":"Evaluation of the Abbott ARCHITECT\u2122 cytomegalovirus IgM\/IgG, rubella IgM\/IgG, and syphilis treponemal antibodies enzyme immunoassays in a mother and child health center population","volume":"94","author":"SG Lapierre","year":"2019","journal-title":"Diagnostic microbiology and infectious disease"},{"issue":"3","key":"pone.0252309.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v058.i03","article-title":"changepoint: An R package for changepoint analysis","volume":"58","author":"R Killick","year":"2014","journal-title":"Journal of statistical software"},{"issue":"8","key":"pone.0252309.ref015","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1017\/S0950268815003167","article-title":"Seroconversion for cytomegalovirus infection in a cohort of pregnant women in Qu\u00e9bec, 2010\u20132013","volume":"144","author":"V Lamarre","year":"2016","journal-title":"Epidemiology & Infection"},{"issue":"1","key":"pone.0252309.ref016","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12884-016-0844-9","article-title":"Awareness of cytomegalovirus and risk factors for susceptibility among pregnant women, in Montreal, Canada","volume":"16","author":"S Wizman","year":"2016","journal-title":"BMC pregnancy and childbirth"},{"key":"pone.0252309.ref017","first-page":"21","article-title":"Congenital cytomegalovirus infection in high-risk Canadian infants: Report of a pilot screening study","author":"W Vaudry","year":"2010","journal-title":"Canadian Journal of Infectious Diseases and Medical Microbiology"},{"issue":"10","key":"pone.0252309.ref018","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1093\/cid\/cit059","article-title":"Prediction of fetal infection in cases with cytomegalovirus immunoglobulin M in the first trimester of pregnancy: a retrospective cohort","volume":"56","author":"M Leruez-Ville","year":"2013","journal-title":"Clinical infectious diseases"},{"issue":"6","key":"pone.0252309.ref019","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/ppe.12320","article-title":"3D Cohort Study: the integrated research network in perinatology of Quebec and Eastern Ontario","volume":"30","author":"WD Fraser","year":"2016","journal-title":"Paediatric and perinatal epidemiology"},{"issue":"1","key":"pone.0252309.ref020","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1471-2334-7-71","article-title":"Incidence of cytomegalovirus infection among the general population and pregnant women in the United States","volume":"7","author":"FA Colugnati","year":"2007","journal-title":"BMC infectious diseases"},{"issue":"11","key":"pone.0252309.ref021","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1086\/652438","article-title":"Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988\u20132004","volume":"50","author":"SL Bate","year":"2010","journal-title":"Clinical infectious diseases"},{"issue":"4","key":"pone.0252309.ref022","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/rmv.655","article-title":"Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection","volume":"20","author":"MJ Cannon","year":"2010","journal-title":"Reviews in medical virology"},{"issue":"8","key":"pone.0252309.ref023","first-page":"577","article-title":"Histoire naturelle des infections \u00e0 cytom\u00e9galovirus","volume":"7","author":"B-M Imbert-Marcille","year":"2001","journal-title":"M\u00e9decine th\u00e9rapeutique"},{"issue":"3","key":"pone.0252309.ref024","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/j.1348-0421.1996.tb03335.x","article-title":"Role of milk whey in the transmission of human cytomegalovirus infection by breast milk","volume":"40","author":"H Asanuma","year":"1996","journal-title":"Microbiology and immunology"},{"issue":"7","key":"pone.0252309.ref025","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1097\/INF.0000000000001877","article-title":"Non-primary maternal CMV infection following viral shedding in infants","volume":"37","author":"I Boucoiran","year":"2018","journal-title":"The Pediatric infectious disease journal"},{"issue":"suppl_1","key":"pone.0252309.ref026","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1093\/jpids\/piu069","article-title":"Mother-to-child transmission of cytomegalovirus and prevention of congenital infection","volume":"3","author":"RF Pass","year":"2014","journal-title":"Journal of the Pediatric Infectious Diseases Society"},{"key":"pone.0252309.ref027","first-page":"1","article-title":"The risk of cytomegalovirus infection in daycare workers: a systematic review and meta-analysis","author":"KR Starke","year":"2020","journal-title":"International archives of occupational and environmental health"},{"issue":"5","key":"pone.0252309.ref028","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1002\/rmv.659","article-title":"Cytomegalovirus seroconversion rates and risk factors: implications for congenital CMV","volume":"20","author":"TB Hyde","year":"2010","journal-title":"Reviews in medical virology"},{"issue":"11","key":"pone.0252309.ref029","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1038\/jp.2013.87","article-title":"Maternal IgG avidity, IgM and ultrasound abnormalities: combined method to detect congenital cytomegalovirus infection with sequelae","volume":"33","author":"M Kaneko","year":"2013","journal-title":"Journal of Perinatology"},{"issue":"4","key":"pone.0252309.ref030","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jcv.2010.12.012","article-title":"Role of prenatal diagnosis and counseling in the management of 735 pregnancies complicated by primary human cytomegalovirus infection: a 20-year experience","volume":"50","author":"MG Revello","year":"2011","journal-title":"Journal of clinical virology"},{"issue":"3","key":"pone.0252309.ref031","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1017\/S0965539599000327","article-title":"Diagnosis and implications of human cytomegalovirus infection in pregnancy","volume":"11","author":"MG Revello","year":"1999","journal-title":"Fetal and Maternal Medicine Review"},{"issue":"8","key":"pone.0252309.ref032","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3390\/v10080405","article-title":"Maternal immunity and the natural history of congenital human cytomegalovirus infection","volume":"10","author":"WJ Britt","year":"2018","journal-title":"Viruses"},{"issue":"1","key":"pone.0252309.ref033","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1017\/S0950268808000551","article-title":"Socioeconomic disparities in the seroprevalence of cytomegalovirus infection in the US population: NHANES III","volume":"137","author":"J Dowd","year":"2009","journal-title":"Epidemiology & Infection"},{"issue":"2316","key":"pone.0252309.ref034","first-page":"1910","article-title":"Statut socio-\u00e9conomique: un facteur de risque ind\u00e9pendant","volume":"58","author":"B Galobardes","year":"2000","journal-title":"M\u00e9decine et hygi\u00e8ne"},{"key":"pone.0252309.ref035","first-page":"40","article-title":"Niveau d\u2019instruction et salaires","author":"LA Jallade","year":"1972","journal-title":"Revue fran\u00e7aise de p\u00e9dagogie"},{"issue":"2","key":"pone.0252309.ref036","doi-asserted-by":"crossref","first-page":"113","DOI":"10.7202\/001077ar","article-title":"La maternit\u00e9 en milieu de travail ou pourquoi les Qu\u00e9b\u00e9coises sont-elles si nombreuses \u00e0 demander un retrait pr\u00e9ventif?","volume":"18","author":"P Bouchard","year":"1986","journal-title":"Sociologie et soci\u00e9t\u00e9s"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T17:33:57Z","timestamp":1624642437000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252309"}},"subtitle":[],"editor":[{"given":"Juliet V.","family":"Spencer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0252309","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]}}}