Maternal Cytomegalovirus Antibodies during Early and Late (Persistent) Phases after Primary Cytomegalovirus Infection during Pregnancy: An Observational Study

Background: We analyzed both early and late (persistent) phases of each cytomegalovirus (CMV) antibody in mothers with primary CMV infection during pregnancy and subsequent congenital CMV infection for a long period from late pregnancy to after delivery using our stored serum samples. Methods: We used stored serum samples obtained during pregnancy to after delivery from mothers with CMV immunoglobulin (Ig) G seroconversion and subsequent infant congenital CMV infection. CMV antibodies, including CMV IgG titer, IgM titer, and IgG avidity, were assessed using the Denka IgG assay, Denka IgM assay Ver.1 and Ver.2, and Enzygnost IgG assay and Denka IgG avidity assay, respectively. We analyzed the dynamics of each CMV antibody for a long period from late pregnancy to after delivery and correlations of each antibody, calculating Pearson's correlation coefficients (R2). Results: We used 67 serum samples obtained from 12 included participants between 2013 and 2018. CMV IgG increased until 61 weeks and did not change significantly after. CMV IgM decreased until 52 weeks and did not change significantly after that in both assays. CMV IgG avidity increased until 64 weeks and did not change significantly after that in both assays. In CMV IgM, a strong positive correlation was found (R2 = 0.9326) between the two different IgM assays. Serum results of the late phase (after 60 weeks) were subsumed into the area of high CMV IgG avidity and low CMV IgM titer, which probably was equivalent to the persistent IgM. Conclusions: CMV antibodies in mothers during the late phase of primary infection were in high IgG avidity and low IgM titer, which probably was equivalent to the persistent IgM.