{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:45:25Z","timestamp":1793191525049,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,9,26]],"date-time":"2019-09-26T00:00:00Z","timestamp":1569456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Congenital cytomegalovirus (cCMV) is the leading non-genetic cause of sensorineural hearing loss (SNHL), and efforts are geared towards prevention through vaccine development. Transmission rates following primary maternal infection occur at rates of 30\u201340%, however reported placental rates upon non-primary maternal infection is reported to be less than &lt;4%. There is significant debate about whether this reduction in transmission rate is due to pre-existing maternal immunity, which could identify possible immunologic targets for vaccines. To address this question, we performed a systemic review of the literature using Preferred Reporting Items for Systematic Review and Analysis (PRISMA) guidelines. We identified cohort studies in high CMV seroprevalent (&gt;80%) areas or in developing regions that examined a cohort of at least 50 infants for congenital CMV acquisition. We identified 19 articles that met criteria and were further categorized based on pre-conception serology, maternal seroprevalence, or previously known seroprevalence. Birth prevalence rates ranged from 0.4% to 6% (median 1.1%), with the studies reporting on clinical outcome (16\/19 studies) noting the majority of infected infants as asymptomatic. We also utilized a recent study that differentiated primary maternal infections from chronic infections in a highly seropositive population to calculate a placental transmission rate in women with pre-existing immunity compared to that of no pre-existing immunity. This work confirms a low cCMV birth prevalence in highly seropositive populations, indicates via a calculated placental transmission rate that the CMV placental transmission rate is lower in non-primary infection than that of primary infection, and reveals gaps in data for further research aiming to identify targets for vaccine development.<\/jats:p>","DOI":"10.3390\/vaccines7040129","type":"journal-article","created":{"date-parts":[[2019,9,27]],"date-time":"2019-09-27T03:03:15Z","timestamp":1569553395000},"page":"129","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Impact of Maternal Immunity on Congenital Cytomegalovirus Birth Prevalence and Infant Outcomes: A Systematic Review"],"prefix":"10.3390","volume":"7","author":[{"given":"Tiziana","family":"Coppola","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Duke University Hospital, Durham, NC, 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse F.","family":"Mangold","sequence":"additional","affiliation":[{"name":"Duke HumanVaccine Institute, Durham, NC, 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cantrell","sequence":"additional","affiliation":[{"name":"Medical Center Library & Archives, Duke University, Durham, NC, 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallie R.","family":"Permar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University Hospital, Durham, NC, 27701, USA"},{"name":"Duke HumanVaccine Institute, Durham, NC, 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/JVI.00030-18","article-title":"Advancing Our Understanding of Protective Maternal Immunity as a Guide for Development of Vaccines to Reduce Congenital Cytomegalovirus Infections","volume":"92","author":"Permar","year":"2018","journal-title":"J. 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