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Congenital cytomegalovirus infection (cCMVi) is the leading cause of nonhereditary sensorineural hearing loss among newborns. Women newly acquiring cytomegalovirus infection (CMVi) during pregnancy have the highest risk of vertical transmission. This study aimed to describe the epidemiology of CMVi in pregnancy in a large healthcare database. A retrospective cohort study was performed using the Maccabi Healthcare Services database (Israel). Women aged 18–44 years old on July 1, 2013 with no record of pregnancy in the prior 6 months were followed through December 31, 2017 for first pregnancy occurrence. Pregnancy outcomes (live birth, spontaneous/therapeutic abortions, stillbirth, and uncertain outcomes) were captured. CMV test results were obtained to assess serostatus at the start of pregnancy (SoP) and primary CMV infection (CMVi) during pregnancy. Associations of demographic and reproductive factors with pCMVi were investigated (multivariable logistic regression). The study included 84 699 pregnant women (median age = 31 years; interquartile range = 28–35). Live birth, fetal loss, and uncertain pregnancy outcomes accounted for 76.8%, 18.2%, and 5.0%, respectively. The seroprevalence of CMV at the start of pregnancy in this cohort was 63.4% (95% confidence interval [CI]: 63.1–63.7). Among seronegative women with available test results (n = 10 657), CMVi incidence was 14.5 per 1000 (95% CI = 12.2–16.7). In multivariate logistic regression models adjusting for maternal age, CMVi was significantly associated with having one or more prior live births (odds ratio [OR]: 3.8 [95% CI: 2.6–5.4]) and having a child less than 6 years of age (OR: 4.3 [95%CI: 3.0–6.1]). One in three pregnant women in Israel is at risk for primary CMVi. This study demonstrates that real‐world electronic healthcare data can be leveraged to support clinical management and development of interventions for congenital CMV by identifying women at high risk for CMVi during pregnancy. Highlights: In an analysis of real‐world data from 84,699 pregnant women from Israel, the seroprevalence of CMV at the start of pregnancy was 63.4%.Among women who were CMV seronegative at the start of pregnancy, the incidence of primary CMV infection was 14.5 per 1000.The incidence of primary CMV infection was higher among multi‐parous women and women with children under six years of age. [ABSTRACT FROM AUTHOR]

Background Congenitally transmitted cytomegalovirus (CMV) is the leading infectious cause of deafness and intellectual impairment among infants. Due to lack of effective preventive and curative treatments, routine CMV screening of pregnant women is generally not recommended by clinical guidelines or public health authorities, but is conducted on an opportunistic basis by specific healthcare systems and providers. This targeted review describes the rate of reported maternal screening for CMV infection and subsequent pregnancy outcomes. Methods PubMed and Embase were searched to identify English-language articles reporting the rate of screening for CMV maternal infection (Objective 1), the acceptance rate for diagnostic amniocentesis (Objective 2), and the elective termination rates due to CMV infection (Objective 3) in Europe and Israel. No date limit was applied. Results Seventeen articles published between 2000 and 2018 were included. Routine CMV screening of pregnant women in the absence of country-level guidelines appears to be common in France and Israel (table). Conversely, in Portugal, where country-level guidelines exist for preconception screening, a high proportion of women are not screened (table). Acceptance rates of diagnostic amniocentesis among women with CMV infection vary considerably across countries, with the highest rates reported in Israel (73%) and the lowest in Italy (16%). Elective termination rates were higher among women who underwent amniocentesis vs. those who did not and those with primary CMV infection vs. those with nonprimary infection. Conversely, one study in Israel showed higher termination rates among patients who did not undergo amniocentesis vs. those who did (35.5% vs. 7.3%). Conclusion The available data indicate that routine screening is carried out in some countries to a variable degree. There is an unmet need for effective prevention and management options to help prevent unnecessary termination of pregnancy. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]