Association of Cytomegalo-Virus and Rubella Virus Infections in Pregnant Women with bad Obstetric History

Abstract

Background: Bad obstetric history (BOH) comprises of previous adverse fetal consequences in terms of two or more successive spontaneous abortions, early neonatal deaths, stillbirths, intrauterine fetal deaths, intrauterine growth retardations and congenital anomalies. The infections which are caused by Rubella virus and CMV during pregnancy are often associated with adverse fetus outcomes and reproductive failures. In the Yemen context, the exact seroprevalence of these infections is not known due to unavailability of baseline data. Objectives: The main aim of this study was to determine the correlation of the main viral TORCH infections (Rubella and CMV) during pregnancy among Yemeni females with BOH. Methods: Two hundred- sixty-eight serum samples were collected from participants having BOH, attending Department of Obstetrics and Gynecology, Al-Sabian University hospital, Sana’a city during the period of September 2017 to September 2018. IgM antibodies for Rubella virus and CMV were detected by micro-capture ELISA tests. Results: The common causes of BOH were abortion (52.6%), intrauterine fetal death (22%) followed by intrauterine growth retardation (10.4%). Fourteen (5.2%) of pregnant women were positive for CMV IgM antibodies, 10 (3.7%) for Rubella IgM antibodies and 4 (1.5%) for CMV- Rubella virus in combination; indicating recent infections. There was significant association between the positive results of anti-CMV IgM -anti-Rubella IgM with age group ≥ 36 years (OR=31,6.2 respectively). Also, there was a significant association between the positive results of anti-CMV IgM with congenital deformation (OR=10.2, p<0.001). Conclusion: IgM antibody positivity was high for Rubella and CMV and there is a strong association of these agents with BOH. Thus, screening and early diagnosis for these pathogens in women can help in proper management of these cases to prevent fetus loss.