Cytomegalovirus (CMV) infection represents the most common viral infection transmitted in-utero and is a significant cause of permanent disabilities such as hearing loss, vision loss, cerebral palsy and /or cognitive impairment in children. The rate of congenital CMV infection ranges from 0.5-0.7% of live births in the US and exceeds 1% in many parts of the world. In light of these facts, it is important to find strategies that will ether prevent or reduce the risk of maternal, and thereby congenital, CMV infection. However, vaccines to prevent maternal infections and congenital CMV infections are not currently available. Our goal is to develop a prenatal screening and brief intervention (SBI) that will focus on the promotion of behaviors that reduce child- to-mother CMV transmission risk among pregnant women in a population that is at increased risk for congenital CMV infection. We will evaluate the efficacy of the intervention by measuring increased knowledge of CMV transmission and prevention measures, increased use of protective behaviors such as hand washing and cleaning environmental surfaces, and decreased practice of risk behaviors such as sharing food, drink or eating utensils used by young children. Pregnant women who are enrolled in prenatal care will be selected to participate in the behavioral intervention group or a comparison group which will receive standard prenatal care. We will also assess the feasibility and acceptability of this approach. A successful intervention that is adaptable on a larger scale to other clinic settings will be invaluable not only for the impact on women's knowledge and behaviors, but also for decreasing CMV infection rates in pregnant women and their offspring. The ultimate goal of an efficacious and acceptable CMV-related behavioral intervention would be to significantly reduce the incidence and burden of congenital CMV infection in the US.
This project will be conducted in a population of pregnant women whose offspring are at increased risk for congenital CMV infection. Development of a scientifically validated intervention to increase maternal cytomegalovirus (CMV) knowledge and promote protective behaviors to reduce CMV infections among pregnant women is needed. Prevention of maternal infection has a direct effect on prevention of congenital CMV infection and the overall disease burden due to CMV infection. Our goals are to evaluate whether a clinic-based screening and intervention focused on pregnant women could increase protective behaviors and decrease risk behaviors related to CMV transmission during pregnancy and to assess the feasibility and acceptability of a large scale expansion of the intervention to other prenatal clinics.
