The geometric mean concentration (GMC) of CMV IgG at an early gestational age in the women who delivered cCMV-positive newborns (i.e., the transmitters) was 854 IU/mL; this was significantly lower than the GMC in the non-transmitters (1101 IU/mL; value from univariate analysis; P2 is the value from multivariate analysis including the variables of maternal age and primiparous status. Antibody change during pregnancy in seropositive women A total of 5537 pregnant women underwent a series of serological tests during pregnancy, and 5284 of those women were successfully followed up until delivery. diagnosed with cCMV contamination. The geometric mean concentration (GMC) of CMV IgG at an early gestational age in the women who delivered cCMV-positive newborns (i.e., the transmitters) was 854 IU/mL; this was significantly lower than the GMC in the non-transmitters (1101 IU/mL; value from univariate analysis; P2 is the value from multivariate analysis including the variables of maternal age and primiparous status. Antibody change during pregnancy in seropositive women A total of 5537 pregnant women underwent a series of serological assessments during pregnancy, and 5284 of those women were successfully followed up until delivery. The GMCs of anti-CMV pp150 IgG in 5537 women during early (Fig.?2a), middle and late gestation were 1097 IU/mL (95% CI: 1073C1121 IU/mL), 1197 IU/mL (95% CI: 1170C1223 IU/mL) and 1221 IU/mL (95% CI: 1195C1249 IU/mL), respectively. The Geniposide IgG Rabbit polyclonal to IGF1R concentration tended to increase with GW (value was calculated by the CochranCArmitage trend test. In each individual, the IgG ratio was calculated by dividing IgG in late gestation by IgG in early gestation, which reflects the fold change in IgG from early to late gestation. The median IgG ratio was 113 (IQR: 100C163) in transmitters and 108 (IQR: 089C135) in non-transmitters. Overall, 7674% (33/43) of transmitters had an IgG ratio greater than 1, which means that the IgG concentration was higher in late gestation than in early gestation; the percentage was lower in non-transmitters (3162/5241, 6033%, P=0040, multivariate logistic analysis) (Fig.?2c). A fourfold increase in IgG (IgG ratio 4) was observed in 698% (3/43) of transmitters and 139% (73/5241) of non-transmitters (P=00077, multivariate logistic analysis), and a twofold increase in IgG (IgG ratio 2) was observed in 1628% (7/43) of transmitters and 786% (412/5241) of non-transmitters (P=0047, multivariate logistic analysis). Through comparison of sociodemographic information in all seropositive pregnant women and seropositive pregnant women with a series of serological assessments (Supplementary material 1), only a very minor difference was shown in residence, which was not a variable significantly related to intrauterine contamination. As a sensitivity analysis, we also performed the above analysis in all seropositive pregnant women, and the results remained comparable (Supplementary material 2). The GW of sample collection in early, middle and late gestation and the GW interval between early and late gestation were comparable between the transmitters and non-transmitters (Supplementary material 3). The risk of cCMV contamination is associated with the pre-existing maternal IgG antibody level A total of 6121 pregnant women underwent IgG testing at an early gestational age received a confirmed diagnosis of newborn cCMV contamination; their data were included in the data set for this part of the study. Four groups were defined according to quartiles of IgG concentration in early gestation (042C655, 655C1223, 1223C1994, 1994 Geniposide and above, IU/mL), and the prevalence rates of cCMV in the four groups were 105% (18/1549, 95% CI: 069C183), 086% (13/1511, 95% CI: 046C147), 072% (11/1531, 95% CI: 036C128) and 039 (6/1530, 95% CI: Geniposide 008C085), respectively; the risk of intrauterine contamination decreased with increasing maternal IgG antibody levels in early gestation as calculated by the CochranCArmitage trend test (Z=-233, P=0020) (Fig.?2d). According to the ROC analysis, the optimal cut-off value for the best differentiation of the low- and high-risk groups was 1283 IU/mL, under which the Youden value was highest (018). Fifteen (051%) of the 2915 women whose IgG levels were higher than 128 IU/mL delivered newborns with cCMV contamination, and the rate was half of that in women whose IgG levels were lower than 1283 IU/mL (106%, 34/3206; RR=045, 95% CI: 024C087, P=0012, Poisson regression analysis). As maternal age differed significantly between the transmitter and non-transmitter groups (Table?1) and GW of sampling was related to IgG levels, the RR was further adjusted for maternal age and GW of sampling at the early gestational age (adjusted RR: 050, 95% CI: 027C093, P=0028, multivariate Poisson regression analysis) (Table?2). Table 2 The association of maternal IgG antibody in early pregnancy with the outcome of cCMV contamination in newborns.