{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:22:04Z","timestamp":1791591724873,"version":"4.3.4"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Due to possible congenital infections, cytomegalovirus (CMV) remains a significant public health concern in childbearing-aged and pregnant women. We analyzed the spatial, temporal, and age-related trends in CMV seroepidemiology in Croatia over 10 years. A total of 2838 childbearing-aged and pregnant women, aged 16\u201345 years, tested between 2015 and 2024 were included in the study. CMV IgM\/IgG antibodies were detected using a commercial ELISA. IgM\/IgG-positive samples were tested for IgG avidity. CMV IgG antibodies were detected in 2006 (70.6%) of participants. No significant differences were observed between 2015\u20132019 and 2020\u20132024 (72.0% vs. 69.8%), while yearly differences were of borderline significance, ranging from 62.4 to 77.3%. The overall seropositivity increased progressively with age from 49.6% in the 16\u201320 age group to 77.5% in the 36\u201340 age group. Significant regional differences in IgG seroprevalence were observed: 68.6% in the City of Zagreb\/Northern Croatia, 78.5% in Pannonian Croatia, and 71.9% in Adriatic Croatia, while differences between settlement types were not significant. IgG seroprevalence was higher in women with an unfavorable obstetric history (85.3%) than in non-pregnant women and those with a normal pregnancy (70.6% and 66.5%, respectively). IgM antibodies were detected in 278 (9.8%) of participants. Acute infections were more common in younger participants, with rates decreasing from 13.6% in the youngest age group to 6.7% in the oldest. Logistic regression showed that age was a significant predictor of both IgG and IgM positivity. Region and obstetric history were significant predictors of IgG seropositivity, while settlement was a significant predictor of IgM seropositivity.<\/jats:p>","DOI":"10.3390\/pathogens14090916","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T15:10:46Z","timestamp":1757603446000},"page":"916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Cytomegalovirus Antibodies in Croatian Childbearing-Aged and Pregnant Women: A Ten-Year Retrospective Study (2015\u20132024)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1877-5547","authenticated-orcid":false,"given":"Tatjana","family":"Vilibi\u0107-\u010cavlek","sequence":"first","affiliation":[{"name":"Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Barbi\u0107","sequence":"additional","affiliation":[{"name":"Statistics Concentrator, Harvard University, Cambridge, MA 02139, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7366-5820","authenticated-orcid":false,"given":"Tadej","family":"Je\u017eek","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3263-1769","authenticated-orcid":false,"given":"Dan","family":"Navolan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Sankovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Applied Health Sciences, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Sviben","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"Department of Parasitology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Glava\u0161","sequence":"additional","affiliation":[{"name":"Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mure\u0219an","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, \u201cIuliu Ha\u1e6dieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurentiu","family":"Pirtea","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Bogdani\u0107","sequence":"additional","affiliation":[{"name":"Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"ref_1","unstructured":"International Committee on Taxonomy of Viruses (ICTV) (2025, July 15). Cytomegalovirus. Available online: https:\/\/ictv.global\/report\/chapter\/orthoherpesviridae\/orthoherpesviridae\/cytomegalovirus."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2034","DOI":"10.1002\/rmv.2034","article-title":"Estimation of the Worldwide Seroprevalence of Cytomegalovirus: A Systematic Review and Meta-Analysis","volume":"29","author":"Zuhair","year":"2019","journal-title":"Rev. Med. Virol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fowler, K., Mucha, J., Neumann, M., Lewandowski, W., Kaczanowska, M., Grys, M., Schmidt, E., Natenshon, A., Talarico, C., and Buck, P.O. (2022). A Systematic Literature Review of the Global Seroprevalence of Cytomegalovirus: Possible Implications for Treatment, Screening, and Vaccine Development. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13971-7"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tzialla, C., Salom\u00e8, S., and Mond\u00ec, V. (2025). Clinical Manifestations of Non-Congenital CMV Infection in Infants and Immunocompetent Children: Review of Cases from the Past Decade. Microorganisms, 13.","DOI":"10.3390\/microorganisms13040772"},{"key":"ref_5","unstructured":"Gupta, M., and Shorman, M. (2025, July 15). Cytomegalovirus Infections, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459185\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1093\/cid\/ciae321","article-title":"Consensus Definitions of Cytomegalovirus (CMV) Infection and Disease in Transplant Patients Including Resistant and Refractory CMV for Use in Clinical Trials: 2024 Update from the Transplant Associated Virus Infections Forum","volume":"79","author":"Ljungman","year":"2024","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pontes, K.F.M., Nardozza, L.M.M., Peixoto, A.B., Werner, H., Tonni, G., Granese, R., and Araujo J\u00fanior, E. (2024). Cytomegalovirus and Pregnancy: A Narrative Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13020640"},{"key":"ref_8","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_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00420-019-01464-x","article-title":"The Risk of Cytomegalovirus Infection in Daycare Workers: A Systematic Review and Meta-Analysis","volume":"93","author":"Kofahl","year":"2020","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schattner, A. (2024). The Wide Spectrum of Presentations of Cytomegalovirus Infection in Immunocompetent Hosts: An Exhaustive Narrative Review. Pathogens, 13.","DOI":"10.3390\/pathogens13080667"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Salom\u00e8, S., Corrado, F.R., Mazzarelli, L.L., Maruotti, G.M., Capasso, L., Blazquez-Gamero, D., and Raimondi, F. (2023). Congenital Cytomegalovirus Infection: The State of the Art and Future Perspectives. Front. Pediatr., 11.","DOI":"10.3389\/fped.2023.1276912"},{"key":"ref_12","unstructured":"Akpan, U.S., and Pillarisetty, L.S. (2025, July 15). Congenital Cytomegalovirus Infection, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/sites\/books\/NBK541003\/."},{"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","unstructured":"\u015awi\u0105tkowska-Freund, M., Bednarek, S., Sasak-Cie\u015blar, N., Koci\u0119cka, N., Powro\u017anik, P., and Waldman, A. (2025). Cytomegalovirus Seroprevalence in Northern Poland in the Population Planning Pregnancy and Pregnant Women. Viruses, 17.","DOI":"10.3390\/v17040537"},{"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":"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_17","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3109\/14767058.2010.485233","article-title":"Seroprevalence of TORCH Infections in Women of Childbearing Age in Croatia","volume":"24","author":"Ban","year":"2011","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Vilibic-Cavlek, T., Kolaric, B., Belamaric, M., Sviben, M., Ferenc, T., Navolan, D., Bekic, V., Milasincic, L., Antolasic, L., and Vilibic, M. (2024). Screening for TORCH Antibodies in Croatian Childbearing-Aged Women, 2014\u20132023. Antibodies, 13.","DOI":"10.3390\/antib13020049"},{"key":"ref_19","unstructured":"Croatian Bureau of Statistics (2025, July 15). The NUTS Classification in Croatia, Available online: https:\/\/dzs.gov.hr\/highlighted-themes\/prostorne-klasifikacije-i-subnacionalne-statistike-2-694\/the-nuts-classification-in-croatia\/699."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"406","DOI":"10.3109\/23744235.2015.1123290","article-title":"Decrease in Seroprevalence for Herpesviruses among Pregnant Women in Finland: Cross-Sectional Study of Three Time Points 1992, 2002 and 2012","volume":"48","author":"Puhakka","year":"2016","journal-title":"Infect. Dis."},{"key":"ref_21","first-page":"2439","article-title":"Cytomegalovirus Seroprevalence in Pregnant Women in the Western Region of Romania: A Large-Scale Study","volume":"20","author":"Gorun","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_22","first-page":"76","article-title":"High Susceptibility to Cytomegalovirus Infection of Pregnant Women in Flanders, Belgium","volume":"4","author":"Leuridan","year":"2012","journal-title":"Facts Views Vis. Obgyn"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1007\/s10096-020-03814-x","article-title":"Thirty Years of CMV Seroprevalence\u2014A Longitudinal Analysis in a German University Hospital","volume":"39","author":"Hoehl","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102537","DOI":"10.1016\/j.jiph.2024.102537","article-title":"Seroprevalence and Age-Related Susceptibility of TORCH Infections in Childbearing Age Women: A 5-Year Cross-Sectional Retrospective Study and a Literature Review","volume":"17","author":"Pavia","year":"2024","journal-title":"J. Infect. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Radoi, C.L., Zlatian, O., Balasoiu, M., Dragomir, T.L., Sorop, M.I., Bagiu, I.C., Boeriu, E., Susan, M., Sorop, B., and Oprisoni, L.A. (2024). Seroprevalence of Anti-Cytomegalovirus Antibodies in Pregnant Women from South-West Romania. Microorganisms, 12.","DOI":"10.3390\/microorganisms12020268"},{"key":"ref_26","first-page":"403","article-title":"Mise en Place du D\u00e9pistage de l\u2019Infection Cong\u00e9nitale \u00e0 Cytom\u00e9galovirus dans une Maternit\u00e9 Fran\u00e7aise de Type 3 [Implementation of Screening for Cytomegalovirus Congenital Infection in a French Type 3 Maternity]","volume":"52","author":"Hamon","year":"2024","journal-title":"Gynecol. Obstet. Fertil. Senol."},{"key":"ref_27","first-page":"E372","article-title":"Seroprevalence of Antibodies to Cytomegalovirus in Pregnant Women in the Apulia Region (Italy)","volume":"62","author":"Trombetta","year":"2021","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Palazzotto, E., Bonura, F., Cal\u00e0, C., Capra, G., Pistoia, D., Mangione, D., Mascarella, C., Min\u00ec, G., Enea, M., and Giammanco, G.M. (2023). Serological Status for TORCH in Women of Childbearing Age: A Decade-Long Surveillance (2012\u20132022) in Italy. J. Med. Microbiol., 72.","DOI":"10.1099\/jmm.0.001733"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1515\/folmed-2017-0036","article-title":"The Role of Cytomegalovirus in Congenital and Early Postnatal Infections in Northeastern Bulgaria","volume":"59","author":"Stoykova","year":"2017","journal-title":"Folia Medica"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/INF.0000000000002510","article-title":"Cytomegalovirus Seroprevalence and Birth Prevalence of Congenital CMV Infection in Bosnia and Herzegovina: A Single-Center Experience","volume":"39","author":"Pati","year":"2020","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e20170313","DOI":"10.1590\/0037-8682-0313-2017","article-title":"Serological Status of Childbearing-Aged Women for Toxoplasma gondii and Cytomegalovirus in Northern Kosovo and Metohija","volume":"52","author":"Pribakovic","year":"2019","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.ijid.2014.03.1365","article-title":"Seroprevalence and Susceptibility to Primary Cytomegalovirus Infection among Childbearing Women","volume":"21","author":"Terzi","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_33","first-page":"55","article-title":"Cytomegalovirus Seroprevalence in Pregnant Women in Madrid: First Step for a Systematic Screening","volume":"41","year":"2023","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/apm.12899","article-title":"Maternal and Congenital Cytomegalovirus Infections in a Population-Based Pregnancy Cohort Study","volume":"126","author":"Barlinn","year":"2018","journal-title":"APMIS"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1017\/S0950268817000103","article-title":"Seroprevalence of Cytomegalovirus Infection in France in 2010","volume":"145","author":"Antona","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"425","DOI":"10.5604\/17331331.1227668","article-title":"High Seroprevalence of CMV among Women of Childbearing Age Implicates High Burden of Congenital Cytomegalovirus Infection in Poland","volume":"65","author":"Siennicka","year":"2017","journal-title":"Pol. J. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kahraman Kilbas, E.P., Ciftci, I.H., Kilbas, I., and Toptan, H. (2025). Seroprevalence of TORCH Viral Agents in Pregnant Women in Turkey: Systematic Review and Meta-Analysis. Pathogens, 14.","DOI":"10.3390\/pathogens14010037"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4274\/tpd.galenos.2022.07379","article-title":"Seroprevalence of Toxoplasma, Rubella and Cytomegalovirus in Women of Fertility Age in Our Region","volume":"47","author":"Karaca","year":"2023","journal-title":"Turkiye Parazitol. Derg."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Pembrey, L., Raynor, P., Griffiths, P., Chaytor, S., Wright, J., and Hall, A.J. (2013). Seroprevalence of Cytomegalovirus, Epstein Barr Virus and Varicella Zoster Virus among Pregnant Women in Bradford: A Cohort Study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081881"},{"key":"ref_40","first-page":"210","article-title":"Low Cytomegalovirus Seroprevalence in Irish Pregnant Women","volume":"98","author":"Knowles","year":"2005","journal-title":"Ir. Med. J."},{"key":"ref_41","first-page":"337","article-title":"Seroprewalencja Zakaze\u0144 Cytomegalowirusem w Populacji Polskich Kobiet Ci\u0119\u017carnych [Seroprevalence of Cytomegalovirus Infection in the Population of Polish Pregnant Women]","volume":"83","author":"Gaj","year":"2012","journal-title":"Ginekol. Pol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00508-016-1069-7","article-title":"Seroepidemiology of Cytomegalovirus Infections in Croatia","volume":"129","author":"Kolaric","year":"2017","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jiph.2013.08.006","article-title":"Cytomegalovirus Seroprevalence in Women with Bad Obstetric History in Kirkuk, Iraq","volume":"7","author":"Aljumaili","year":"2014","journal-title":"J. Infect. Public Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.micpath.2017.10.014","article-title":"Cytomegalovirus Infection in Pregnant Women and Its Association with Bad Obstetric Outcomes in Northern India","volume":"113","author":"Fatima","year":"2017","journal-title":"Microb. Pathog."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mocanu, A.G., Stoian, D.L., Daescu, A.-M.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_46","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"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/916\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:43:54Z","timestamp":1760035434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/916"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":46,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["pathogens14090916"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14090916","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]}}}