Interpretation
Ascendant transmission from genital tract appears to be an important
transmission route1. According to Rocha and colleagues
(2012), after detection CMV in cervical samples of asymptomatic women at
reproductive age, this could be a great method of pregnant women
accompaniment that may reactivate the infection or have primo-infection
under asymptomatic way27. Thus, it could be suggested
that this might be the transmission pathway, once in the present study
the placenta is apparently involved only in a single case. One-third of
parturients with intrauterine infected newborns did not have a fixed
partner, and besides the viral reactivation hypothesis due to a
concomitant infection24, it might have happened
reinfection by other CMV subtypes during the gestation period caused by
sexual intercourse exposure.
Women at risk of transmitting CMV to the fetus should perform
noninvasive tests, such as ultrasonographic monitoring of the fetus
(that is able to detect malformations and signs of fetal infection) and
even invasive tests such as cordocentesis and amniocentesis2,16. Among those neonates presenting the virus in
cord blood only one presented ears malformation and micrognatia, besides
prematurity and low weight at birth. Concerning this specific case, as
observed in at least three more cases, mother realized no accompaniment
examns during gestation period. Therefore, it is not possible to affirm
for sure that the virus prevalence and this characteristic are
correlated, once the mother was carrying other conditions that might
have caused the proper scenario for this closure. However, this
possibility should be strongly considered.
Relevant socio-economic factors such as malnutrition, inappropriate
health care services and bad hygiene contribute to maternal-fetal
infection increase in developing coutries17.
Concerning the present study, the sociodemographic factors such as skin
color and schooling have demonstrated a tendency in mother infection by
CMV. Besides, the exposure time to the virus might be important,
principally in reactivation cases. Women’s early onset of sexual
intercourse, before 15 years old, was a risk factor to the virus
presence in the umbilical cord blood. Therefore, the exposure certainly
occurs and women carrying CMV can probably go under reactivation and
transmit the virus to fetus. Simultaneously to the income factor, which
was statistically significant, these data indicate that the lack of
knowledge concerning the disease and preventive measures, as well as
lack of sanitary conditions, commonly observed in poor populations, are
strongly connected in this scenario.