While you may not have heard of CMV, or cytomegalovirus, it’s something all pregnant women should know about. Dr Hayley Smithers-Sheedy, a research fellow with the Cerebral Palsy Alliance, shares how best to avoid it.
What is CMV?
“CMV is a common herpes virus,” says Hayley. “It circulates widely in our community and by young adulthood, half of us have been infected with CMV – and we won’t know that we’ve been infected because there are almost no symptoms – or only a mild flu-like illness when we’re infected.”
Hayley says that most of the time the virus doesn’t cause any major ramifications for our health. Unless you’re pregnant. “It’s just in the case of maternal infection that we have more concerns about CMV,” she says.
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CMV during pregnancy
According to Hayley, the greatest risk for the developing baby is an infection in the first half of pregnancy. “A mother in that time has the greatest risk of passing the virus onto the developing baby,” she says.
When Pam was 26 weeks pregnant, she was measuring quite small at a routine midwife check-up. After further monitoring, she discovered her baby had an abnormality in his brain and there was a 98 percent chance that she’d passed CMV to the baby.
Back at around 15 weeks, Pam remembers feeling really tired but was told with work and pregnancy that this was not unusual. “They were able to look back at blood that had been taken throughout the earlier stages of pregnancy versus those taken later and they were able to pinpoint that that was around the time that I contracted CMV,” she says. “And it’s thought that it pretty much crossed the placenta straight away.”
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How does CMV affect the unborn child?
“Every year in Australia, there’ll be around 2,000 babies born with congenital CMV and 400 of those babies will have long term outcomes and those outcomes can range from things like, most predominantly, hearing loss and deafness,” says Hayley. “It’s a very common outcome of congenital CMV infection, particularly in babies who are symptomatic at birth, but also there’s a proportion that will go on to have other complications including epilepsy, cerebral palsy and intellectual impairment.”
For Pam’s baby, the effects were so serious that a termination was offered at 31 weeks. “The virus had attacked around that key point of pregnancy where the brain does all of its major development movement and it had so severely affected his brain that it didn’t develop properly,” says Pam. “So secondary to CMV, my beautiful Christopher has been diagnosed with microcephaly, severe global developmental delays, cerebral palsy, epilepsy, a cortical vision impairment, unilateral hearing loss, residual constipation and hip dysplasia.”
But don’t panic
While this outcome was severe, Hayley tells pregnant mums to not panic. “Most babies that are born with CMV will be perfectly healthy, but a proportion of babies will have quite significant long-term outcomes, even stillbirth or neonatal death,” she says. “It’s a nasty virus – try to avoid it in pregnancy, but keep in mind that most babies will be fine.”
Prevention is best
CMV is commonly passed through saliva and contact with urine, so Hayley suggests that if you’re pregnant or planning a pregnancy and you look after young children, the best thing you can do is be careful about taking proper hygiene precautions on a day-to-day basis.
“Just simple things like washing your hands with soap and water after you change nappies, not sharing cutlery and not putting the kid’s dummy in your mouth,” she says.
Lip kisses with your toddler are also best avoided. “It doesn’t mean that you can’t give your toddler a lovely big kiss on the nose or on the cheek or on the head and big hugs, but probably just try to avoid that lip-to-lip contact with saliva during the time you’re pregnant.”
There are a host of foods and activities we avoid when pregnant, and CMV needs to be on that list. “If we can put the same care that we do around these simple hygiene precautions, particularly if you’ve got kids at home or you’re a childcare worker, then we’re going to reduce our risk of severe infection in pregnancy,” says Hayley.
Onward and upwards
Christopher is now five and making enormous progress. “He attends kindergarten with all his other friends, and he’s doing really well,” says Pam. “It’s obviously not without its challenges, but he’s such a superstar and we’re on bonus time with him because we were told that we wouldn’t get our boy – and now he’s now five and I get to kiss him goodnight every night”
Pam and her family are not only doing an incredible job of looking after Christopher, giving him the very best quality of life that they can, but also raising much-needed awareness about CMV. Not many pregnant women would risk eating soft cheese during pregnancy. Avoiding CMV should be just as seriously considered.