Consensus document from six Italian Scientific Societies on the management of cytomegalovirus (CMV) congenital infection

Human cytomegalovirus (CMV) is the most common cause of intrauterine infection, occurring in 0.2% to 2.2% of all live births, and congenital infection is a common cause of sensorineural hearing loss and mental retardation. Transmission to fetus may occur through primary or secondary maternal infection with a probability of 30% to 40%, intrauterine transmission following primary infection during pregnancy compared with 0.5% to 2.2 % following secondary infection. Approximately 10-15% of congenitally infected babies are symptomatic at birth and these infants have a perinatal mortality rate of around 10% with 70-80% of surviving babies presenting major neurological sequelae. Despite infection, 85-90% of babies have no symptoms at birth however 8-15% of them will suffer from psychomotor and sensory-neural disabilities. The management of congenital CMV infections varies considerably in different centers and often there are unequal methods used between practitioners, which can lead to substantial discrepancies between the indications suggested by the literature and what is actually performed. A multidisciplinary group of 30 experts and/or qualified representatives of the six Italian Scientific Societies of Clinical Microbiologists (AMCLI), Gynaecology and Obstetrics (SIGO), Sexually Transmitted Diseases (SIMaST), Infectious and Tropical Diseases (SIMIT), Neonatology (SIN) and Pediatrics (SIP) developed evidence and expert opinion-20 based consensus guidelines on CMV congenital infection management including mechanism of pathogenesis, clinical and epidemiological aspects, prevention, diagnostics, and treatments. Each section used a scoring system to rate the quality of evidence on which recommendations are based.The document was prepared, discussed and validated by multidisciplinary committee through a consensus conference