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Table 1 Data sources and parameters regarding cytomegalovirus infection during pregnancy, potential screening tests and hygiene measures

From: Hygiene promotion might be better than serological screening to deal with Cytomegalovirus infection during pregnancy: a methodological appraisal and decision analysis

Parameter Sources Best estimate Min-Max Comments
Sero-prevalence in 15–49 years-old women [97] 45.6% 25.2–61.0% Robust French representative survey
Incidence of MPI   1.0% 0.2–1.4% Mean incidence and mean of CI lower and higher limits (expert consensus)
Transmission rate from mother to foetus [19, 36, 53, 84, 87, 98,99,100] 40.0% 5.0–72.2% Mean transmission rates and CI lower and higher limits from studies reporting rates by trimester of pregnancy
Transmission rate from mother to foetus (1st trimester) [39, 88, 98, 101] 19% NA Mean incidence (expert consensus); screening scenario only
Transmission rate from mother to foetus (2nd trimester) [39, 88, 98, 101] 36% NA Mean incidence (expert consensus); screening scenario only
Transmission rate after reinfectionb [42, 102,103,104]    Unknown; assumed equal to transmission after MPI
Proportion of infected newborns who are symptom free [2, 4, 105, 106] 87.3% Min: 75.0% Stable across studies
Proportion of medical TOP among MPI or infected foetus [2, 4, 20, 23, 25, 39, 41, 43, 74, 88, 89, 105, 107,108,109,110,111,112,113,114,115,116,117,118,119,120] 9.2% NA Data from National Reference Laboratory and literature
Proportion of medical TOP after screening [85, 103] 95.0% NA Foetal infections confirmed by amniocentesis, positive or not at echography
Prevalence of infection at birth [1, 2, 4, 38, 42, 68, 69, 97, 98, 112, 121] 0.43% 0.20–0.61% Min-max from European studies, vary with selection and tests
Proportion of infected newborns who are symptomatic [2, 4, 88, 105, 106] 12.7% NA Do not include TOP, part of whom would have diedc
Proportion of infected newborns who are symptomatic born from mothers with immunity prior to pregnancy [38, 39, 42, 105, 122] 12.7% NA Stable across studies
Incidence of hearing impairment between birth and 5 years among asymptomatic newborns with sequelae [9] 53.0% NA  
Frequency of any sequelae in asymptomatic newborns [4, 11, 12, 43, 98, 106, 123, 124] 13.3% NA  
Frequency of any severe sequelae in severe symptomatic newborns [4, 9, 10, 19, 42, 43, 162, 163, 173] 47.0% NA Middle of value range
Frequency of any moderate sequela in severe symptomatic newborns [4, 9, 19, 42, 43, 105, 106, 124] 25.0% NA Middle of value range
Frequency of any moderate sequela in moderately symptomatic newborns [4, 9, 19, 42, 43, 105, 106, 124] 16.0% NA Middle of value range
Proportion of any severe symptomatic newborns without sequela [105] 28.0% NA Middle of value range
Proportion of any moderately symptomatic newborns without sequela [105] 51.0% NA Middle of value range
Frequency of any severe sequelae in moderately symptomatic newborns [105] 33.0% NA Middle of value range
Proportion of any late sequelae among symptomatic newborns with sequelae [105, 106, 125] 43.0% NA  
Sensitivity IgG [126,127,128] 99.7%   Diasorin test; false negative women considered negatives, but MPI and consequences considered in truly infected women
Specificity IgG [126,127,128] 99.4%   Abbott test; false positive women considered positives, but MPI and consequences considered in truly infected women
Sensitivity IgM [128,129,130,131] 94.0% 79.4–95.9%a Vidas, Beckman-Coulter, Diasorin, Roche, Siemen HC tests
Specificity IgM [128,129,130,131,132] 99.3% 96.4–100%a  
Sensitivity avidity of IgG [23, 34, 36, 109, 131, 133,134,135,136,137,138,139,140,141,142] 83,0%   During first 12 weeks of pregnancy; applied when IgM positive
Specificity avidity of IgG [23, 34, 133,134,135,136,137,138,139,140,141,142,143] 82,0%   During first 12 weeks of pregnancy; applied when IgM positive
Absolute reduction with hygiene [63] −50%   Group consensus on most plausible result
  1. MPI maternal primary infection; TOP termination of pregnancy; a Maximum values are point estimates from studies not providing confidence intervals; b, unknown, considered equal to previous line; NA: min-max not considered in robustness analyses; c Min = 0 from [4] disregarded by group as not plausible