Rubella and CMV Antibodies Screening During Pregnancy - A Retrospective Study in a Tertiary Hospital
Background: In India, RUBELLA & CMV Antibodies screening is routinely carried out, but due to absence of clear intervention, its value is questionable. This retrospective study evaluated the usefulness of rubella & cmv antibody screening during pregnancy. Methods: Blood is collected from pregnant women & children, tested for rubella and CMV specific IgM Antibody by capture ELISA. The data were analysed to determine the incidence of rubella &CMV infection during pregnancy & in congenital infections. Results: In asymptomatic pregnancy females (n=252) rubella positivity was 1.58% and in woman with BOH (n=110) it was 3.66%, while CMV passivity was 2.9% in both asymptomatic and BOH women. In children (n=100) the overall positivity for rubella and CMV specific IgM antibodies was 7.5% and 12.5% respectively. The incidence of rubella and CMV infections in pregnant women & women with BOH has declined. In children, also the congenital rubella syndrome has declined but for the past 5 years the incidence of CMV infection remained same without any change. Conclusions: The incidence of rubella over the past 5 years can be reduced after giving the rubella vaccine to school going girls & women with reproductive age apart from routine vaccine. But CMV infection is a big problem due to unavailability of vaccine & safe treatment against CMV infection, so routine screening for rubella and CMV should be reserved for women with obstetric complications only.
2. Singh MP, Arora S, Das A, et al. Congenital rubella and cytomegalovirus infections in and around Chandigarh. Ind J Pathol Microbiol. 2009;52(1):46–48. doi: 10.4103/0377-4929.44962.
3. Cutts FT, Robertson SE, Diaz-Ortega JL, et al. Control of rubella and congenital rubella syndrome (CRS) in developing countries, part 1: burden of diseases from CRS. Bull World Health Organ. 1997;75:55–68.
4. Khan NA, Kazzi SN. Yield and costs of screening growth-retarded infants for TORCH infections. AmJ Perinatal. 2000;17:131. doi: 10.1055/s-2000-9288.
5. Cullen A, Brown S, Cafferkey M, et al. Current use of the TORCH screen in the diagnosis of congenital infection. J Infect. 1998;36:185.
6. Garland SM, Gilbert GL. Investigation of congenital infection—the TORCH screen is not a legitimate test. Paediatric infectious diseases group of the Australian Society for infectious diseases. Med J Aust. 1993;159:346.
7. Le Land D, French ML, Kleiman MB, et al. The use of TORCH titers. Pediatrics. 1983;72(1):41–43.
8. Ahlfors K, Ivarsson SA, Harris S. Report on a long term study of maternal and congenital cytomegalovirus infection in Sweden: review of prospective studies available in the literature. Scand J Infect Dis. 1999;31:443–457. doi: 10.1080/00365549950163969.
9. Hagay ZJ, Biran G, Ornoy A. Congenital cytomegalovirus infection: a long standing problem still seeking a solution. Am J Obstet Gynecol. 1996;174:241–245. doi: 10.1016/S0002-9378(96)70401-5.
10. Gandhoke I, Aggarwal A, Lal S, et al. Seroprevalence and incidence of rubella in and around Delhi (1988–2002) Indian J Med Microbiol. 2005;23:164–167. doi: 10.4103/0255-0857.16587.
11. Fomda BA, Thokar MA, Farooq U, et al. Seroprevalence of rubella in pregnant women in Kashmir. Indian J Pathol Microbiol. 2004;47:435–437.
12. Singla N, Jindal N, Aggarwal A. Primary rubella virus infection: prevalence and relationship to pregnancy to pregnancy wastage. Indian J Pathol Microbiol. 2003;46:688–689.
13. Kaur R, Gupta N, Nair D, et al. Screening for TORCH infections in pregnant women: a report from Delhi. Southeast Asian J Trop Med Public Health. 1999;30:284–286.
14. Thapliyal N, Shukla PK, Kumar B, et al. TORCH infection in women with bad obstetric history: a pilot study in Kumaon region. Indian J Pathol Microbiol. 2005;48:551–553.
15. Yadav S, Gupta S, Kumari S. Seroprevalence of rubella in women of reproductive age. Indian J Pathol Microbiol. 1995;38(2):139–142.
16. Gupta E, Dar L, Broor S. Seroprevalence of rubella in pregnant women in Delhi, India. Indian J Med Res. 2006;123:833–835.
17. Turbadkar D, Mathur D, Rele M. Seroprevalence of TORCH infection in bad obstetric history. Indian J Med Microbiol. 2003;21:108–110.
18. Broor S, Kapil A, Kishore J, et al. Prevalence of rubella virus and cytomegalovirus infections in suspected cases of congenital infections. Indian J Pediatr. 1991;58:75–78. doi: 10.1007/BF02810416.
19. Gandhoke I, Aggarwal A, Lal S, et al. Congenital CMV infection in symptomatic infants in Delhi and surrounding areas. Indian J Pediatr. 2006;73:1095–1097. doi: 10.1007/BF02763052.