Cytomegalovirus: “Systematic screening of pregnant women is a health and ethical emergency”

Cytomegalovirus (CMV) is a common viral infection, affecting a large portion of the population, but often overlooked due to its mild or absent symptoms. The leading cause of congenital infection in France, this virus can, however, pose a considerable risk to the fetus if contracted early in pregnancy. It can cause developmental delays, psychological disorders, or deafness in 4 out of 1,000 newborns. Each year, 800 children are born with disabilities due to CMV infection.

These risks can be prevented by advising pregnant women who are not immune to avoid contact with the bodily fluids of an infected infant. However, infection most often occurs from a firstborn in community care, where 80% of children shed the virus.

Therefore, the introduction of systematic serological screening for CMV in pregnant women becomes obvious and a health and ethical emergency.

Knowledge about CMV has advanced considerably in recent decades. If the infection is detected early, antiviral treatments, whose safety is clearly established, and other medical interventions can reduce the risk of transmission to the fetus and, consequently, the risk of sequelae in the child. However, without systematic screening, these solutions remain out of reach for many women. Routine prenatal ultrasound identifies less than half of serious fetal infections when the pregnant woman's infection status is unknown. However, guided by this knowledge, the examination is extremely relevant.

Today, only well-informed women – or those monitored by trained professionals – benefit from optimal care within a genuine care pathway.

The argument in favor of this screening goes beyond purely medical considerations to be rooted in fundamental ethical principles, including information, which is at the heart of informed decision-making, and equal opportunity for medical management of the risk of fetal infection. Indeed, knowledge of the risks associated with CMV allows women to exercise their individual freedom by choosing to undergo screening to maximize their chances of preventing this infection in the fetus and, if necessary, to benefit from early treatment.

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