{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:17:36Z","timestamp":1789993056531,"version":"4.0.1"},"reference-count":92,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Congenital cytomegalovirus (CMV) infection is the most common intrauterine viral infection with a significant impact on the foetus and newborn. Current diagnostic practice includes serological testing for specific antibodies, but there are no global screening protocols. Maternal CMV screening is often performed in conjunction with antenatal ultrasound. While most infections are asymptomatic, severe cases can lead to long-term disability or death. Antiviral therapies, mainly ganciclovir and valganciclovir, are reserved for symptomatic patients, especially those with central nervous system involvement. Although effective, these treatments are associated with significant side effects such as neutropenia and hepatotoxicity. Foscarnet and cidofovir are used as alternatives, but their efficacy and safety require further study in paediatric patient populations. The effectiveness of passive prophylaxis is still uncertain. The lack of universally accepted guidelines for diagnosis, treatment, and prevention and the risk of serious side effects highlight the need for continued research. This review evaluates current therapeutic strategies, discusses their efficacy and associated risks, and highlights the need for innovative approaches to improve outcomes for affected neonates.<\/jats:p>","DOI":"10.3390\/clinpract14060191","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T09:36:51Z","timestamp":1731404211000},"page":"2445-2462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Progress and Challenges in the Management of Congenital Cytomegalovirus Infection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5243-4537","authenticated-orcid":false,"given":"Weronika","family":"Szulc","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-3672","authenticated-orcid":false,"given":"Natalia","family":"Szyd\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9115-0543","authenticated-orcid":false,"given":"Julia M.","family":"Smyk","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7452","authenticated-orcid":false,"given":"Anna","family":"Majewska","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mocanu, A.G., Stoian, D.L., Daescu, A.C., Motofelea, A.C., Ciohat, I.M., Navolan, D.B., Vilibic-Cavlek, T., Bogdanic, M., Nemescu, D., and Tomescu, L. (2024). The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women. Microorganisms, 12.","DOI":"10.3390\/microorganisms12040731"},{"key":"ref_2","unstructured":"Louten, J. (2022). Essential Human Virology, Elsevier. [2nd ed.]. Cytomegalovirus."},{"key":"ref_3","unstructured":"Gupta, M., and Shorman, M. (2024, July 07). Cytomegalovirus. StatPearls Publishing, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459185\/."},{"key":"ref_4","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":"Kenneson","year":"2007","journal-title":"Rev. Med. Virol."},{"key":"ref_5","first-page":"e00055-20","article-title":"Updates on cytomegalovirus infection: Epidemiology, prevention, and treatment","volume":"34","author":"Quirk","year":"2021","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.ajog.2020.05.038","article-title":"Timing of primary maternal cytomegalovirus infection and rates of vertical transmission and fetal consequences","volume":"223","author":"Chatzakis","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_7","first-page":"100289","article-title":"Evaluating the impact of vaccination campaigns on the spread of infectious diseases in Europe","volume":"14","author":"Schmidt","year":"2024","journal-title":"Lancet Reg. Health-Eur."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jcv.2009.11.009","article-title":"Human cytomegalovirus in utero transmission: Follow-up of 524 maternal seroconversions","volume":"47","author":"Zech","year":"2010","journal-title":"J. Clin. Virol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1002\/pd.2654","article-title":"Periconceptional cytomegalovirus infection: Pregnancy outcome and rate of vertical transmission","volume":"30","author":"Hadar","year":"2010","journal-title":"Prenat. Diagn."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1002\/pd.4118","article-title":"A series of 238 cytomegalovirus primary infections during pregnancy: Description and outcome","volume":"33","author":"Picone","year":"2013","journal-title":"Prenat. Diagn."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342.e1","DOI":"10.1016\/j.ajog.2011.05.030","article-title":"Pregestational, periconceptional, and gestational primary maternal cytomegalovirus infection: Prenatal diagnosis in 508 pregnancies","volume":"205","author":"Feldman","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_12","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":"Revello","year":"2011","journal-title":"J. Clin. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jcv.2011.07.005","article-title":"Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age","volume":"52","author":"Enders","year":"2011","journal-title":"J. Clin. Virol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1093\/cid\/ciy1128","article-title":"Sequelae of congenital cytomegalovirus following maternal primary infections are limited to those acquired in the first trimester of pregnancy","volume":"69","author":"Magny","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","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":"Pass","year":"2006","journal-title":"J. Clin. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1016\/S1473-3099(17)30143-3","article-title":"Congenital cytomegalovirus infection in pregnancy and the neonate: Consensus recommendations for prevention, diagnosis, and therapy","volume":"17","author":"Rawlinson","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/QCO.0000000000000317","article-title":"Update on treatment of cytomegalovirus infection in pregnancy and of the newborn with congenital cytomegalovirus","volume":"29","author":"Rawlinson","year":"2016","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ejogrb.2021.01.035","article-title":"Perspectives of women on screening and prevention of CMV in pregnancy","volume":"258","author":"Beaudoin","year":"2021","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"100892","DOI":"10.1016\/j.lanepe.2024.100892","article-title":"Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)","volume":"40","author":"Chatzakis","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1002\/uog.26226","article-title":"Cost-effectiveness of screening and valacyclovir-based treatment strategies for first-trimester cytomegalovirus primary infection in pregnant women in France","volume":"62","author":"Lepers","year":"2023","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Iijima, S. (2022). Pitfalls in the Serological Evaluation of Maternal Cytomegalovirus Infection as a Potential Cause of Fetal and Neonatal Involvements: A Narrative Literature Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175006"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lazzarotto, T., Bl\u00e1zquez-Gamero, D., Delforge, M.L., Foulon, I., Luck, S., Modrow, S., and Leruez-Ville, M. (2020). Congenital Cytomegalovirus Infection: A Narrative Review of the Issues in Screening and Management from a Panel of European Experts. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00013"},{"key":"ref_23","first-page":"436","article-title":"Congenital cytomegalovirus infection diagnostics and management","volume":"35","author":"Pinninti","year":"2022","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"138","DOI":"10.12688\/f1000research.10276.1","article-title":"Cytomegalovirus in pregnancy and the neonate","volume":"6","author":"Emery","year":"2017","journal-title":"F1000Research"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1002\/pd.5107","article-title":"Amniocentesis for prenatal diagnosis of cytomegalovirus infection: Challenging the 21 weeks\u2019 threshold","volume":"37","author":"Enders","year":"2017","journal-title":"Prenat. Diagn."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ejogrb.2024.01.037","article-title":"Counseling in fetal medicine: Congenital cytomegalovirus infection","volume":"295","author":"Rizzo","year":"2024","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jcv.2019.05.015","article-title":"Primary cytomegalovirus (CMV) infection in pregnancy: Diagnostic value of CMV PCR in saliva compared to urine at birth","volume":"117","author":"Exler","year":"2019","journal-title":"J. Clin. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/cid\/ciw707","article-title":"Prediction of congenital cytomegalovirus infection in high-risk pregnant women","volume":"64","author":"Tanimura","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"463","DOI":"10.5468\/ogs.23117","article-title":"Cytomegalovirus infection during pregnancy","volume":"66","author":"Choodinatha","year":"2023","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_30","first-page":"457","article-title":"Neuropathogenesis of Congenital Cytomegalovirus Infection: Disease Mechanisms and Prospects for Intervention","volume":"6","author":"Cheeran","year":"2009","journal-title":"Annu. Rev. Virol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1097\/INF.0000000000001763","article-title":"ESPID Congenital CMV Group Meeting, Leipzig 2015. Congenital Cytomegalovirus: A European Expert Consensus Statement on Diagnosis and Management","volume":"36","author":"Luck","year":"2017","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S490","DOI":"10.1093\/clinids\/10.Supplement_3.S490","article-title":"Antiviral activity and mechanism of action of ganciclovir","volume":"10","author":"Matthews","year":"1998","journal-title":"Rev. Infect. Dis."},{"key":"ref_33","unstructured":"(2024, July 07). DRUGBANK Online: Ganciclovir. Available online: https:\/\/go.drugbank.com\/drugs\/DB01004."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.3109\/14767058.2015.1058774","article-title":"Anti-viral therapy for congenital cytomegalovirus infection: Pharmacokinetics, efficacy and side effects","volume":"29","author":"Mareri","year":"2016","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.2174\/13895575113136660088","article-title":"Antiviral medication in sexually, transmitted diseases. Part I: HSV, HPV","volume":"13","author":"Majewska","year":"2013","journal-title":"Mini-Rev. Med. Chem."},{"key":"ref_36","unstructured":"Demmler-Harrison, G.J., and Weisman, L.E. (2024, July 07). Congenital Cytomegalovirus Infection: Management and Outcome. Waltham, MA: UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/congenital-cytomegalovirus-infection-management-and-outcome."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mondal, D. (2016). Valganciclovir. Reference Module in Biomedical Sciences, Elsevier.","DOI":"10.1016\/B978-0-12-801238-3.99406-6"},{"key":"ref_38","unstructured":"(2024, July 07). DRUGBANK Online: Valganciclovir. Available online: https:\/\/go.drugbank.com\/drugs\/DB01610."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1136\/archdischild-2022-323809","article-title":"Managing challenges in congenital CMV: Current thinking","volume":"108","author":"Jones","year":"2023","journal-title":"Arch. Dis. Child."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1086\/528376","article-title":"Pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease","volume":"197","author":"Kimberlin","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s40746-022-00261-y","article-title":"Perinatal Cytomegalovirus Infection","volume":"8","author":"Carmona","year":"2022","journal-title":"Curr. Treat. Options Peds"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"384","DOI":"10.3345\/cep.2022.01032","article-title":"Treatment of congenital cytomegalovirus infection","volume":"66","author":"Shim","year":"2023","journal-title":"Clin. Exp. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S0022-3476(03)00192-6","article-title":"National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: A randomized, controlled trial","volume":"143","author":"Kimberlin","year":"2003","journal-title":"J. Pediatr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1086\/516445","article-title":"Ganciclovir treatment of symptomatic congenital cytomegalovirus infection: Results of a phase II study. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group","volume":"175","author":"Whitley","year":"1997","journal-title":"J. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/01.inf.0000069767.43169.2d","article-title":"Treatment of children with congenital cytomegalovirus infection with ganciclovir","volume":"22","author":"Michaels","year":"2003","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.jpeds.2010.02.020","article-title":"Is a 6-week course of ganciclovir therapy effective for chorioretinitis in infants with congenital cytomegalovirus infection?","volume":"157","author":"Shoji","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1056\/NEJMoa1404599","article-title":"Valganciclovir for symptomatic congenital cytomegalovirus disease","volume":"372","author":"Kimberlin","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s00431-010-1176-9","article-title":"Treatment of symptomatic congenital cytomegalovirus infection with intravenous ganciclovir followed by long-term oral valganciclovir","volume":"169","author":"Amir","year":"2010","journal-title":"Eur. J. Pediatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s00430-017-0512-3","article-title":"Intrauterine therapy of cytomegalovirus infection with valganciclovir: Review of the literature","volume":"206","author":"Seidel","year":"2017","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s10156-010-0204-z","article-title":"Efficacy of prolonged valganciclovir therapy for congenital cytomegalovirus infection","volume":"17","author":"Kashiwagi","year":"2011","journal-title":"J. Infect. Chemother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1136\/archdischild-2015-309154","article-title":"Hearing outcome of infants with congenital cytomegalovirus and hearing impairment","volume":"101","author":"Bilavsky","year":"2016","journal-title":"Arch. Dis. Child."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1093\/tropej\/fmq050","article-title":"Effect on hearing of oral valganciclovir for asymptomatic congenital cytomegalovirus infection","volume":"57","author":"Vardar","year":"2011","journal-title":"J. Trop. Pediatr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jcv.2012.06.001","article-title":"Treatment of symptomatic congenital cytomegalovirus infection beyond the neonatal period","volume":"55","author":"Reyes","year":"2012","journal-title":"J. Clin. Virol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.3109\/14767058.2012.663832","article-title":"Congenital cytomegalovirus infection following antenatal negative diagnostic amniotic fluid analysis-a single center experience","volume":"25","author":"Yogev","year":"2012","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/j.1442-200X.2010.03217.x","article-title":"Oral valganciclovir treatment for congenital cytomegalovirus infection","volume":"53","author":"Imamura","year":"2011","journal-title":"Pediatr. Int."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1007\/s10096-009-0806-5","article-title":"Oral valganciclovir treatment in newborns with symptomatic congenital cytomegalovirus infection","volume":"28","author":"Lombardi","year":"2009","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_57","first-page":"347","article-title":"Symptomatic congenital Cytomegalovirus deafness: The impact of a six-week course of antiviral treatment on hearing improvement","volume":"25","author":"Mazzaferri","year":"2017","journal-title":"Infez. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.braindev.2015.08.003","article-title":"Neurological outcomes in symptomatic congenital cytomegalovirus-infected infants after introduction of newborn urine screening and antiviral treatment","volume":"38","author":"Nishida","year":"2016","journal-title":"Brain Dev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"113934","DOI":"10.1016\/j.jpeds.2024.113934","article-title":"Oral Valganciclovir Initiated Beyond 1 Month of Age as Treatment of Sensorineural Hearing Loss Caused by Congenital Cytomegalovirus Infection: A Randomized Clinical Trial","volume":"268","author":"Kimberlin","year":"2024","journal-title":"J. Pediatr."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1272\/jnms.79.471","article-title":"A neonate with reduced cytomegalovirus DNA copy number and marked improvement of hearing in the treatment of congenital cytomegalovirus infection","volume":"79","author":"Hayakawa","year":"2012","journal-title":"J. Nippon. Med. Sch."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1055\/s-0029-1234076","article-title":"Oral Valganciclovir treatment in a CMV congenital infected infant with sensorineural hearing loss (SNHL) first detected at 4 months of age","volume":"221","author":"Hilgendorff","year":"2009","journal-title":"Klin. Padiatr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jiac.2024.03.006","article-title":"Assessment of patients\u2019 characteristics associated with the efficacy and safety of oral valganciclovir treatment for infants with symptomatic congenital cytomegalovirus disease","volume":"30","author":"Kakei","year":"2024","journal-title":"J. Infect. Chemother."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00431-006-0109-0","article-title":"Valganciclovir for treatment of congenital cytomegalovirus infection","volume":"165","author":"Schulzke","year":"2006","journal-title":"Eur. J. Pediatr."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Suganuma, E., Oka, A., Sakata, H., Adachi, N., Asanuma, S., Oguma, E., Yamaguchi, A., Furuichi, M., Uejima, Y., and Sato, S. (2018). 10-year follow-up of congenital cytomegalovirus infection complicated with severe neurological findings in infancy: A case report. BMC Pediatr., 18.","DOI":"10.1186\/s12887-018-1348-8"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Chiopris, G., Veronese, P., Cusenza, F., Procaccianti, M., Perrone, S., Dacc\u00f2, V., Colombo, C., and Esposito, S. (2020). Congenital cytomegalovirus infection: Update on diagnosis and treatment. Microorganisms, 8.","DOI":"10.3390\/microorganisms8101516"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"104231","DOI":"10.1016\/j.jcv.2019.104231","article-title":"Blood viral load in the diagnostic workup of congenital cytomegalovirus infection","volume":"122","author":"Smiljkovic","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Majewska, A., and Mlynarczyk-Bonikowska, B. (2022). 40 Years after the Registration of Acyclovir: Do We Need New Anti-Herpetic Drugs?. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23073431"},{"key":"ref_68","unstructured":"Garikapati, S., and Nguyen, M. (2024, July 07). Foscarnet. StatPearls Publishing, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556108\/."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1080\/14767050410001701349","article-title":"Foscarnet therapy for congenital cytomegalovirus liver fibrosis following prenatal ascites","volume":"15","author":"Nigro","year":"2004","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/00365540600786598","article-title":"A haemophagocytic lymphohistiocytosis (HLH)-like picture following breastmilk transmitted cytomegalovirus infection in a preterm infant","volume":"39","author":"Knorr","year":"2007","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_71","unstructured":"(2024, July 07). DRUGBANK Online: Cidofovir. Available online: https:\/\/go.drugbank.com\/drugs\/DB00369."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/(SICI)1099-1654(199709)7:3<145::AID-RMV196>3.0.CO;2-0","article-title":"Clinical uses of cidofovir","volume":"7","author":"Safrin","year":"1997","journal-title":"Rev. Med. Virol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJMoa1913569","article-title":"Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal\u2013Fetal Medicine Units Network. A Trial of Hyperimmune Globulin to Prevent Congenital Cytomegalovirus Infection","volume":"385","author":"Hughes","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1056\/NEJMc2308286","article-title":"Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal\u2013Fetal Medicine Units Network. Randomized trial of hyperimmune globulin for congenital CMV infection\u20142-year outcomes","volume":"389","author":"Hughes","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1515\/jpm-2011-0257","article-title":"Use of cytomegalovirus hyperimmunoglobulin for prevention of congenital cytomegalovirus disease: A retrospective analysis","volume":"40","author":"Buxmann","year":"2012","journal-title":"J. Perin Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1080\/14767058.2017.1387890","article-title":"Prevention and treatment of fetal cytomegalovirus infection with cytomegalovirus hyperimmune globulin: A multicenter study in Madrid","volume":"32","year":"2019","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/GCO.0000000000000486","article-title":"Antenatal treatment options for primary cytomegalovirus infections","volume":"30","author":"Kagan","year":"2018","journal-title":"Curr. Opin. Obs. Gynecol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1056\/NEJMoa043337","article-title":"Congenital Cytomegalovirus Collaborating Group. Passive immunization during pregnancy for congenital cytomegalovirus infection","volume":"353","author":"Nigro","year":"2005","journal-title":"N. Eng. J. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1056\/NEJMoa1310214","article-title":"A randomized trial of hyperimmune globulin to prevent congenital cytomegalovirus","volume":"370","author":"Revello","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1056\/NEJMc1405377","article-title":"Hyperimmune globulin to prevent congenital CMV infection","volume":"370","author":"Pajkrt","year":"2014","journal-title":"N. Eng. J. Med."},{"key":"ref_81","unstructured":"Japanese Congenital Cytomegalovirus Infection Immunoglobulin Fetal Therapy Study Group (2012). A trial of immunoglobulin fetal therapy for symptomatic congenital cytomegalovirus infection. J. Rep. Immunol., 95, 73\u201379. Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/22884280\/."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.jogc.2018.03.013","article-title":"Use of cytomegalovirus-specific hyperimmunoglobulins in pregnancy: A retrospective cohort","volume":"40","author":"Minsart","year":"2018","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/S0002-9378(99)70620-4","article-title":"Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection and growth restriction","volume":"180","author":"Nigro","year":"1999","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/uog.26136","article-title":"Effectiveness and safety of prenatal valacyclovir for congenital cytomegalovirus infection: Systematic review and meta-analysis","volume":"61","author":"Marinceu","year":"2023","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/uog.26039","article-title":"New data on efficacy of valacyclovir in secondary prevention of maternal-fetal transmission of cytomegalovirus","volume":"61","author":"Egloff","year":"2023","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ajog.2023.07.022","article-title":"The effect of valacyclovir on secondary prevention of congenital cytomegalovirus infection, following primary maternal infection acquired periconceptionally or in the first trimester of pregnancy. An individual patient data meta-analysis","volume":"230","author":"Chatzakis","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/S0140-6736(20)31868-7","article-title":"Valaciclovir to prevent vertical transmission of cytomegalovirus after maternal primary infection during pregnancy: A randomised, double-blind, placebo-controlled trial","volume":"396","author":"Pardo","year":"2020","journal-title":"Lancet"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"462.e1","DOI":"10.1016\/j.ajog.2016.04.003","article-title":"In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicenter, open-label, phase II study","volume":"215","author":"Ghout","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_89","unstructured":"(2024, July 07). UpToDate: Patient Education: Avoiding Infections in Pregnancy (Beyond the Basics). Available online: https:\/\/www.uptodate.com\/contents\/avoiding-infections-in-pregnancy-beyond-the-basics."},{"key":"ref_90","unstructured":"(2024, July 07). CDC: Cytomegalovirus (CMV) and Congenital CMV Infection, Available online: www.cdc.gov\/cmv\/index.html."},{"key":"ref_91","unstructured":"(2024, July 07). ClinicalTrials.gov: A Study to Evaluate the Efficacy, Safety, and Immunogenicity of mRNA-1647 Cytomegalovirus (CMV) Vaccine in Healthy Participants 16 to 40 Years of Age, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05085366."},{"key":"ref_92","unstructured":"(2024, July 07). Moderna Clinical Trials: A Clinical Trial of a Cytomegalovirus (CMV) Vaccine in Healthy Women 16 to 40 Years of Age. Available online: https:\/\/trials.modernatx.com\/study\/?id=mRNA-1647-P301."}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/6\/191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:30:33Z","timestamp":1760113833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/6\/191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,12]]},"references-count":92,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["clinpract14060191"],"URL":"https:\/\/doi.org\/10.3390\/clinpract14060191","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,12]]}}}