{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:15:24Z","timestamp":1787030124187,"version":"build-2736575974"},"reference-count":90,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Cytomegalovirus (CMV) is the most common cause of congenital infections in developed countries because is capable of infecting the fetus after both primary and recurrent maternal infection, and because the virus may be spread for years through infected children. Moreover, CMV is the most serious congenital infection associated with severe neurological and sensorineural sequelae, which can occur at birth or develop later on. Hygienic measures can prevent CMV transmission, which mainly involve contact with children under 3 years of age and attending a nursery or daycare. In animal and human pregnancies, many observational and controlled studies have shown that CMV-specific hyperimmune globulin (HIG) is safe and can significantly decrease maternal\u2013fetal transmission of CMV infection and, mostly, the occurrence of CMV disease. Recently, valaciclovir at the dosage of 8 g\/day was also reported to be capable of decreasing the rates of congenital infection and disease. However, comparing the results of our two recent case series, the infants born to women treated with HIG showed significantly lower rates of CMV DNA positivity in urine (9.7% vs. 75.0%; p &lt; 0.0001) and abnormalities after follow-up (0.0% vs. 41.7%; p &lt; 0.0001). The implementation of CMV screening would enable primary prevention via hygiene counseling, improve the understanding and awareness of congenital CMV infection, and increase the knowledge of the potential efficacy of preventive or therapeutic HIG or antiviral administration.<\/jats:p>","DOI":"10.3390\/v15061376","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T01:31:31Z","timestamp":1686879091000},"page":"1376","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Prevention of Congenital Cytomegalovirus Infection: Review and Case Series of Valaciclovir versus Hyperimmune Globulin Therapy"],"prefix":"10.3390","volume":"15","author":[{"given":"Giovanni","family":"Nigro","sequence":"first","affiliation":[{"name":"Non-Profit Association Mother-Infant Cytomegalovirus Infection (AMICI), 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-2393","authenticated-orcid":false,"given":"Mario","family":"Muselli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Congenital Cytomegalic Disease Collaborating Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"ref_1","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":"Cannon","year":"2010","journal-title":"Rev. Med. Virol"},{"key":"ref_2","unstructured":"Knipe, D., and Howley, P. (2007). Fields\u2019 Virology, Lippincott Williams & Wilkins. [5th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/rmv.544","article-title":"New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection","volume":"17","author":"Dollard","year":"2007","journal-title":"Rev. Med. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/GCO.0b013e328342f1f6","article-title":"Cytomegalovirus infections during pregnancy","volume":"23","author":"Nigro","year":"2011","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/00006454-199202000-00007","article-title":"Symptomatic congenital cytomegalovirus infection: Neonatal morbidity and mortality","volume":"11","author":"Boppana","year":"1992","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.jpeds.2005.09.003","article-title":"Hearing loss in children with congenital cytomegalovirus infection born to mothers with preexisting immunity","volume":"148","author":"Ross","year":"2006","journal-title":"J. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1097\/INF.0b013e3181723d55","article-title":"Congenital cytomegalovirus infection in a highly seropositive semi-urban population in India","volume":"27","author":"Dar","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1097\/INF.0b013e31822d9640","article-title":"Congenital Cytomegalovirus Infection as a Cause of Sensorineural Hearing Loss in a Highly Immune Population","volume":"30","author":"Yamamoto","year":"2011","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_9","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_10","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_11","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_12","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1080\/14787210.2017.1398081","article-title":"Hyperimmune globulin in pregnancy for prevention of congenital cytomegalovirus disease","volume":"15","author":"Nigro","year":"2017","journal-title":"Expert. Rev. Anti. Infect. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104732","DOI":"10.1016\/j.antiviral.2020.104732","article-title":"The direct and indirect consequences of cytomegalovirus infection and potential benefits of vaccination","volume":"176","author":"Griffiths","year":"2020","journal-title":"Antiviral. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2116","DOI":"10.1016\/S0140-6736(04)16500-8","article-title":"Importance of cytomegalovirus viraemia in risk of disease progression and death in HIV-infected patients receiving highly active antiretroviral therapy","volume":"363","author":"Deayton","year":"2004","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1111\/j.1600-6143.2012.04087.x","article-title":"Cytomegalovirus replication kinetics in solid organ transplant recipients managed by preemptive therapy","volume":"12","author":"Atabani","year":"2012","journal-title":"Am. J. Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1574-6976.1999.tb00408.x","article-title":"The pathogenicity of cytomegalovirus","volume":"23","author":"Sweet","year":"1999","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Arvin, A., Campadelli-Fiume, G., Mocarski, E., Moore, P.S., Roizman, B., Whitley, R., and Yamanishi, K. (2007). Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis, Cambridge University Press. Chapter 41.","DOI":"10.1017\/CBO9780511545313"},{"key":"ref_18","unstructured":"Remington, J.S., and Klein, J.O. (2006). Diseases of the Fetus and Newborn Infant, Elsevier Saunders. [6th ed.]. Chapter 23."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.tim.2005.02.009","article-title":"Insights into viral transmission at the uterine-placental interface","volume":"13","author":"Pereira","year":"2005","journal-title":"Trends. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1086\/512245","article-title":"Development of human cytomegalovirus-specific T cell immunity during primary infection of pregnant women and its correlation with virus transmission to the fetus","volume":"195","author":"Lilleri","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1086\/507634","article-title":"Placental enlargement in women with primary maternal cytomegalovirus infection is associated with fetal and neonatal disease","volume":"43","author":"Nigro","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/14767050802609767","article-title":"Maternal-fetal cytomegalovirus infection: From diagnosis to therapy","volume":"22","author":"Nigro","year":"2009","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1186\/s12985-020-01463-2","article-title":"Toll-like receptor-mediated innate immunity against herpesviridae infection: A current perspective on viral infection signaling pathways","volume":"17","author":"Zheng","year":"2020","journal-title":"Virol. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"386","DOI":"10.3389\/fcimb.2020.00386","article-title":"Genetic and Functional Characterization of Toll-Like Receptor Responses in Immunocompetent Patients with CMV Mononucleosis","volume":"10","author":"Frascaroli","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1002\/art.24487","article-title":"Generalized Wegener\u2019s granulomatosis in an immunocompetent adult after cytomegalovirus mononucleosis and bacterial urinary tract infection","volume":"60","author":"Varani","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Hamilton, S.T., Scott, G., Naing, Z., Iwasenko, J., Hall, B., Graf, N., Arbuckle, S., Craig, M.E., and Rawlinson, W.D. (2012). Human cytomegalovirus-induces cytokine changes in the placenta with implications for adverse pregnancy outcomes. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0052899"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bourgon, N., Fitzgerald, W., Aschard, H., Magny, J.F., Guilleminot, T., Stirnemann, J., Romero, R., Ville, Y., Margolis, L., and Leruez-Ville, M. (2022). Profile and concentration of cytokines fractions in amniotic 2 fluid of fetuses infected with cytomegalovirus. Viruses, 14.","DOI":"10.3390\/v14102145"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1038\/nri.2016.38","article-title":"T cell responses to cytomegalovirus","volume":"16","author":"Klenerman","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s00430-019-00598-6","article-title":"Generation, maintenance and tissue distribution of T cell responses to human cytomegalovirus in lytic and latent infection","volume":"208","author":"Jackson","year":"2019","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Manandhar, T., H\u00f2, G.G.T., Pump, W.C., Blasczyk, R., and Bade-Doeding, C. (2019). Battle between Host Immune Cellular Responses and HCMV Immune Evasion. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20153626"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/s41577-019-0225-5","article-title":"Modulation of innate and adaptive immunity by cytomegaloviruses","volume":"20","author":"Berry","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3389\/fcimb.2020.00283","article-title":"In Vivo Downregulation of MHC Class I Molecules by HCMV Occurs during All Phases of Viral Replication but Is Not Always Complete","volume":"10","author":"Gabor","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"202","DOI":"10.3389\/fcimb.2020.00202","article-title":"The CD4+ T Cell Response to Human Cytomegalovirus in Healthy and Immunocompromised People","volume":"10","author":"Lim","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Adamson, C.S., and Nevels, M.M. (2020). Bright and Early: Inhibiting Human Cytomegalovirus by Targeting Major Immediate-Early Gene Expression or Protein Function. Viruses, 12.","DOI":"10.3390\/v12010110"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Poole, E., and Sinclair, J. (2020). Understanding HCMV Latency Using Unbiased Proteomic Analyses. Pathogens, 9.","DOI":"10.3390\/pathogens9070590"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"E118","DOI":"10.1097\/TP.0000000000003138","article-title":"New Insights into the Molecular Mechanisms and Immune Control of Cytomegalovirus Reactivation","volume":"104","author":"Forte","year":"2020","journal-title":"Transplantation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1046\/j.1471-0528.2003.01302.x","article-title":"Congenital Cytomegalic Disease Collaborating Group. Clinical manifestations and abnormal laboratory findings in pregnant women with primary cytomegalovirus infection","volume":"110","author":"Nigro","year":"2003","journal-title":"Brit. J. Obstet. Gynaecol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"466","DOI":"10.2174\/187152611797636703","article-title":"Overview of the diagnosis of cytomegalovirus infection","volume":"11","author":"Ross","year":"2011","journal-title":"Infect. Disord. Drug Targets"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/jmv.23863","article-title":"The combination of specific IgM antibodies and IgG antibodies of low avidity does not always indicate primary infection with cytomegalovirus","volume":"86","author":"Lumley","year":"2014","journal-title":"J. Med. Virol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1097\/PAT.0b013e328353bec0","article-title":"Comparison of five CMV IgM immunoassays with CMV IgG avidity for diagnosis of primary CMV infection","volume":"44","author":"BaAlawi","year":"2012","journal-title":"Pathology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1128\/CVI.00487-14","article-title":"Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy","volume":"21","author":"Prince","year":"2014","journal-title":"Clin. Vaccine. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1002\/uog.6129","article-title":"Cytomegalovirus-related fetal brain lesions: Comparison between targeted ultrasound examination and magnetic resonance imaging","volume":"32","author":"Benoist","year":"2008","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1002\/pd.366","article-title":"Intraventricular haemorrhage in a fetus with cerebral cytomegalovirus infection","volume":"22","author":"Nigro","year":"2002","journal-title":"Prenat. Diagn."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1111\/j.1469-0691.2011.03564.x","article-title":"Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy","volume":"17","author":"Lazzarotto","year":"2011","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/pd.2037","article-title":"Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection","volume":"28","author":"Picone","year":"2008","journal-title":"Prenat. Diagn."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"638.e1","DOI":"10.1016\/j.ajog.2016.06.003","article-title":"Primary maternal cytomegalovirus infections: Accuracy of fetal ultrasound for predicting sequelae in offspring","volume":"215","author":"Leyder","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3760","DOI":"10.1007\/s00330-015-4187-0","article-title":"Congenital cytomegalovirus infection: Contribution and best timing of prenatal MR imaging","volume":"26","author":"Cannie","year":"2016","journal-title":"Eur. Radiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1053\/j.sult.2015.04.001","article-title":"Fetal Brain Magnetic Resonance Imaging Findings in Congenital Cytomegalovirus Infection with Postnatal Imaging Correlation","volume":"36","author":"Averill","year":"2015","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1093\/cid\/ciz1030","article-title":"Congenital Cytomegalic Disease Collaborating Group. High-dose cytomegalovirus (CMV) hyperimmune globulin and maternal CMV DNAemia independently predict infant outcome in pregnant women with a primary CMV infection","volume":"71","author":"Nigro","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"983","DOI":"10.3109\/14767058.2010.547963","article-title":"Role of the infections in recurrent spontaneous abortion","volume":"24","author":"Nigro","year":"2011","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1128\/JCM.40.5.1767-1772.2002","article-title":"Real-time PCR quantification of human cytomegalovirus DNA in amniotic fluid samples from mothers with primary infection","volume":"40","author":"Gouarin","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1093\/infdis\/jiz447","article-title":"The Status of Vaccine Development Against the Human Cytomegalovirus","volume":"221","author":"Plotkin","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/infdis\/jiac131","article-title":"Derisking Human Cytomegalovirus Vaccine Clinical Development in Relevant Preclinical Models","volume":"226","author":"Permar","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/infdis\/jiac129","article-title":"Horizontal Transmission of Cytomegalovirus in a Rhesus Model Despite High-Level, Vaccine-Elicited Neutralizing Antibody and T-Cell Responses","volume":"226","author":"Li","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jpeds.2004.05.041","article-title":"Prevention of child-to-mother transmission of cytomegalovirus among pregnant women","volume":"145","author":"Adler","year":"2004","journal-title":"J. Pediatr."},{"key":"ref_56","unstructured":"(2023, March 27). Congenital CMV Infection, Available online: https:\/\/www.cdc.gov\/cmv\/clinical\/congenital-cmv.html."},{"key":"ref_57","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_58","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S0022-3476(94)70327-2","article-title":"Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: A two-regimen experience","volume":"124","author":"Nigro","year":"1994","journal-title":"J. Pediatr."},{"key":"ref_59","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_60","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1097\/00006454-200208000-00023","article-title":"Placental transfer of ganciclovir in a woman with acquired immunodeficiency syndrome and cytomegalovirus disease","volume":"21","author":"Brandy","year":"2002","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1399-3062.2005.00089.x","article-title":"Successful use of oral ganciclovir for the treatment of intrauterine cytomegalovirus infection in a renal allograft recipient","volume":"7","author":"Puliyanda","year":"2005","journal-title":"Transpl. Infect. Dis."},{"key":"ref_62","first-page":"2506","article-title":"Prenatal Treatment of Congenital Cytomegalovirus with Valganciclovir: A Case Report","volume":"71","author":"DeNoble","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1111\/j.1471-0528.2007.01308.x","article-title":"Maternal administration of valaciclovir in symptomatic intrauterine cytomegalovirus infection","volume":"114","author":"Jacquemard","year":"2007","journal-title":"BJOG"},{"key":"ref_64","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_65","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_66","doi-asserted-by":"crossref","first-page":"104351","DOI":"10.1016\/j.jcv.2020.104351","article-title":"Valacyclovir in primary maternal CMV infection for prevention of vertical transmission: A case-series","volume":"127","author":"Apicella","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1002\/uog.23685","article-title":"Secondary prevention of congenital cytomegalovirus infection with valacyclovir following maternal primary infection in early pregnancy","volume":"58","author":"Fourgeaud","year":"2021","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e01627\u201320","DOI":"10.1128\/AAC.01627-20","article-title":"Investigational Antiviral Therapy Models for the Prevention and Treatment of Congenital Cytomegalovirus Infection during Pregnancy","volume":"65","author":"Hamilton","year":"2021","journal-title":"Antimicrob. Agents. Chemother."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1886560","DOI":"10.1080\/21645515.2021.1886560","article-title":"Polyclonal hyper immunoglobulin: A proven treatment and prophylaxis platform for passive immunization to address existing and emerging diseases","volume":"18","author":"Tharmalingam","year":"2022","journal-title":"Human Vacc. Immunother."},{"key":"ref_70","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. Obstet. Gynecol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1056\/NEJMoa043337","article-title":"Congenital Cytomegalic Disease Collaborating Group. Passive maternal immunization during pregnancy for congenital cytomegalovirus infection","volume":"353","author":"Nigro","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/pd.2013","article-title":"Regression of fetal cerebral abnormalities by primary cytomegalovirus infection following hyperimmunoglobulin therapy","volume":"28","author":"Nigro","year":"2008","journal-title":"Prenat. Diagn."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.2353\/ajpath.2010.091210","article-title":"Antibody Treatment Promotes Compensation for Human Cytomegalovirus-Induced Pathogenesis and a Hypoxia-Like Condition in Placentas with Congenital Infection","volume":"177","author":"Maidji","year":"2010","journal-title":"Am. J. Pathol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1093\/cid\/cis423","article-title":"Early Primary Cytomegalovirus Infection in Pregnancy: Maternal Hyperimmunoglobulin Therapy Improves Outcomes Among Infants at 1 Year of Age","volume":"55","author":"Visentin","year":"2012","journal-title":"Clin. Infect. Dis."},{"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. P\u00e9rinat. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.3109\/14767058.2012.684111","article-title":"Fetal hyperechogenic bowel may indicate congenital cytomegalovirus disease responsive to immunoglobulin therapy","volume":"25","author":"Nigro","year":"2012","journal-title":"J. Matern. Fetal. Neonatal. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/infdis\/jir718","article-title":"Immunoglobulin therapy of fetal cytomegalovirus infection occurring in the first half of pregnancy\u2014A case-control study of the outcome in children","volume":"205","author":"Nigro","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3109\/14767058.2013.806899","article-title":"Effective management and intrauterine treatment of congenital cytomegalovirus infection: Review article and case series","volume":"27","author":"Wagner","year":"2014","journal-title":"J. Matern. Fetal. Neonatal. 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":"209","DOI":"10.1159\/000381626","article-title":"Passive immunization against congenital cytomegalovirus infection: Current state of knowledge","volume":"95","author":"Rothenburger","year":"2015","journal-title":"Pharmacology"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s00404-018-4703-y","article-title":"No evidence of obstetrical adverse events after hyperimmune globulin application for primary cytomegalovirus infection in pregnancy: Experience from a single centre","volume":"297","author":"Neuberger","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1007\/s00404-020-05728-7","article-title":"Fetal and maternal outcome after hyperimmunoglobulin administration for prevention of maternal\u2013fetal transmission of cytomegalovirus during pregnancy: Retrospective cohort analysis","volume":"302","author":"Seidel","year":"2020","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJMoa1913569","article-title":"A trial of hyperimmune globulin to prevent congenital cytomegalovirus infection","volume":"385","author":"Hughes","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_84","first-page":"2544","article-title":"Hyperimmune globulin to prevent congenital CMV infection","volume":"370","author":"Nigro","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1056\/NEJMc2114296","article-title":"Hyperimmune globulin for congenital cytomegalovirus infection","volume":"386","author":"Nigro","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1002\/uog.19164","article-title":"Prevention\u2009of\u2009maternal\u2013fetal\u2009transmission\u2009of cytomegalovirus after primary maternal infection in the first trimester by biweekly hyperimmunoglobulin administration","volume":"53","author":"Kagan","year":"2019","journal-title":"Ultrasound Obstetr. Gynecol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/uog.23596","article-title":"Outcome of pregnancies with recent primary cytomegalovirus infection in first trimester treated with hyperimmunoglobulin: Observational study","volume":"57","author":"Kagan","year":"2021","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3109\/14767058.2014.907265","article-title":"Primary maternal cytomegalovirus infections during pregnancy: Association of CMV hyperimmune globulin with gestational age at birth and birth weight","volume":"28","author":"Nigro","year":"2015","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1128\/CMR.00023-08","article-title":"Neuropathogenesis of congenital cytomegalovirus infection: Disease mechanisms and prospects for intervention","volume":"22","author":"Cheeran","year":"2009","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/rmv.1790","article-title":"Universal newborn screening for congenital CMV infection: What is the evidence of potential benefit?","volume":"24","author":"Cannon","year":"2014","journal-title":"Rev. Med. 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