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Efficient Linking of Birth Certificate and Newborn Screening Databases for Laboratory Investigation of Congenital Cytomegalovirus Infection and Preterm Birth: Florida, 2008

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Abstract

The objectives of this study are (1) to design an accurate method for linking newborn screening (NBS) and state birth certificate databases to create a de-identified study database; (2) To assess maternal cytomegalovirus (CMV) seroprevalence by measuring CMV IgG in newborn dried blood spots; (3) To assess congenital CMV infection among newborns and possible association with preterm birth. NBS and birth databases were linked and patient records were de-identified. A stratified random sample of records based on gestational age was selected and used to retrieve blood spots from the state NBS laboratory. Serum containing maternal antibodies was eluted from blood spots and tested for the presence of CMV IgG. DNA was extracted from blood spots and tested for the presence of CMV DNA. Analyses were performed with bivariable and multivariable logistic regression models. Linkage rates and specimen collection exceeded 98% of the total possible yielding a final database with 3,101 newborn blood spots. CMV seroprevalence was 91% among Black mothers, 83% among Hispanic mothers, 59% among White mothers, and decreased with increasing amounts of education. The prevalence of CMV infection in newborns was 0.45% and did not vary significantly by gestational age. Successful methods for database linkage, newborn blood spots collection, and de-identification of records can serve as a model for future congenital exposure surveillance projects. Maternal CMV seroprevalence was strongly associated with race/ethnicity and educational level. Congenital CMV infection rates were lower than those reported by other studies and lacked statistical power to examine associations with preterm birth.

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References

  1. Kenneson, A., & Cannon, M. J. (2007). Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Reviews in Medical Virology, 17(4), 253–276.

    Article  PubMed  Google Scholar 

  2. Dollard, S. C., Grosse, S. D., & Ross, D. S. (2007). New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Reviews in Medical Virology, 17(5), 355–363.

    Article  PubMed  Google Scholar 

  3. Boppana, S. B., Pass, R. F., Britt, W. J., Stagno, S., & Alford, C. A. (1992). Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. The Pediatric Infectious Disease Journal, 11(2), 93–99.

    Article  PubMed  CAS  Google Scholar 

  4. Istas, A. S., Demmler, G. J., Dobbins, J. G., & Stewart, J. A. (1995). Surveillance for congenital cytomegalovirus disease: a report from the national congenital cytomegalovirus disease registry. Clinical Infectous Disease, 20(3), 665–670.

    Article  CAS  Google Scholar 

  5. Nance, W. E., Lim, B. G., & Dodson, K. M. (2006). Importance of congenital cytomegalovirus infections as a cause for pre-lingual hearing loss. Journal of Clinical Virology, 35(2), 221–225.

    Article  PubMed  Google Scholar 

  6. Maruyama, K., Koizumi, T., & Hirato, J. (2006). Cytomegalovirus infections associated hemophagocytic lymphohistiocytosis in a premature infant. Pediatrics International, 48(6), 648–650.

    Article  PubMed  Google Scholar 

  7. Terry, N. E., & Fowler, C. L. (2006). Cytomegalovirus enterocolitis complicated by perforated appendicitis in a premature infant. Journal of Pediatric Surgery, 41(8), 1476–1478.

    Article  PubMed  Google Scholar 

  8. Nagy, A., Endreffy, E., Streitman, K., Pinter, S., & Pusztai, R. (2004). Incidence and outcome of congenital cytomegalovirus infection in selected groups of preterm and full-term neonates under intensive care. In Vivo, 18(6), 819–823.

    PubMed  Google Scholar 

  9. Zurabishvili, S., Mamamtavrishvili, I., Apridonidze, K., & Shanidze, L. (2005). Role of intracellular infections in premature childbirth. Georgian Medical News, 126, 58–60.

    Google Scholar 

  10. Prosch, S., Lienicke, U., Priemer, C., Flunker, G., Seidel, W. F., Kruger, D. H., et al. (2002). Human adenovirus and human cytomegalovirus infections in preterm newborns: no association with bronchopulmonary dysplasia. Pediatric Research, 52(2), 219–224.

    Article  PubMed  Google Scholar 

  11. Lu, S. C., Chin, L. T., Wu, F. M., Hsieh, G. J., Haung, S. P., Chen, J. C., et al. (1999). Seroprevalence of CMV antibodies in a blood donor population and premature neonates in the south-central Taiwan. Kaohsiung Journal of Medical Sciences, 15(10), 603–610.

    PubMed  CAS  Google Scholar 

  12. Reyes, C., Pereira, S., Warden, M. J., & Sills, J. (1997). Cytomegalovirus enteritis in a premature infant. Journal of Pediatric Surgery, 32(11), 1545–1547.

    Article  PubMed  CAS  Google Scholar 

  13. Pereira, L., Maidji, E., McDonagh, S., & Tabata, T. (2005). Insights into viral transmission at the uterine-placental interface. Trends in Microbiology, 13(4), 164–174.

    Article  PubMed  CAS  Google Scholar 

  14. Maidji, E., McDonagh, S., Genbacev, O., Tabata, T., & Pereira, L. (2006). Maternal antibodies enhance or prevent cytomegalovirus infection in the placenta by neonatal Fc receptor-mediated transcytosis. American Journal of Pathology, 168(4), 1210–1226.

    Article  PubMed  CAS  Google Scholar 

  15. McDonagh, S., Maidji, E., Chang, H. T., & Pereira, L. (2006). Patterns of human cytomegalovirus infection in term placentas: A preliminary analysis. Journal of Clinical Virology, 35(2), 210–215.

    Article  PubMed  CAS  Google Scholar 

  16. Romero, R., Espinoza, J., Goncalves, L. F., Kusanovic, J. P., Friel, L., & Hassan, S. (2007). The role of inflammation and infection in preterm birth. Seminars in Reproductive Medicine, 25(1), 21–39.

    Article  PubMed  CAS  Google Scholar 

  17. Haddad, R., Tromp, G., Kuivaniemi, H., Chaiworapongsa, T., Kim, Y. M., Mazor, M., et al. (2006). Spontaneous labor at term is characterized by a genomic signature of acute inflammation in the chorioamniotic membranes but not in the systemic circulation. American Journal Obstetrics and Gynecology, 195(2), 1–24.

    Google Scholar 

  18. Barbi, M., Binda, S., & Caroppo, S. (2006). Diagnosis of congenital CMV infection via dried blood spots. Reviews in Medical Virology, 16(6), 385–392.

    Article  PubMed  Google Scholar 

  19. Kharrazi, M., Hyde, T., Young, S., Amin, M. M., Cannon, M. J., & Dollard, S. C. (2010). Use of screening dried blood spots for estimation of prevalence, risk factors, and birth outcomes of congenital cytomegalovirus infection. Journal of Pediatrics, 157(2), 191–197.

    Article  PubMed  Google Scholar 

  20. Boppana, S., Ross, S. A., et al. (2010). Dried blood spot real-time polymerase chain reaction assays to screen newborns for congenital cytomegalovirus infection. Journal of the American Medical Association, 303, 1375–1382.

    Article  PubMed  CAS  Google Scholar 

  21. McManemy, J., Cooke, E., Amon, E., & Leet, T. (2007). Recurrence risk for preterm delivery. American Journal of Obstetrics and Gynecology, 196(6):576 e1-6, discussion e6-7.

    Google Scholar 

  22. Adams, M. M., Elam-Evans, L. D., Wilson, H. G., & Gilbertz, D. A. (2000). Rates of and factors associated with recurrence of preterm delivery. Journal of the American Medical Association, 283(12), 1591–1596.

    Article  PubMed  CAS  Google Scholar 

  23. Kotelchuck, M. (1994). An evaluation of the kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84(9), 1414–1420.

    Article  PubMed  CAS  Google Scholar 

  24. Mercader, S., Featherstone, D., & Bellini, W. J. (2006). Comparison of available methods to elute serum from dried blood spot samples for measles serology. Journal of Virological Methods, 137(1), 140–149.

    Article  PubMed  CAS  Google Scholar 

  25. Shibata, M., Takano, H., Hironaka, T., & Hirai, K. (1994). Detection of human cytomegalovirus DNA in dried newborn blood filter paper. Journal of Virological Methods, 46(2), 279–285.

    Article  PubMed  CAS  Google Scholar 

  26. Barbi, M., Binda, S., Caroppo, S., & Primache, V. (2006). Neonatal screening for congenital cytomegalovirus infection and hearing loss. Journal of Clinical Virology, 35(2), 206–209.

    Article  PubMed  Google Scholar 

  27. Boppana, S. B., Fowler, K. B., Pass, R. F., Rivera, L. B., Bradford, R. D., Lakeman, F. D., et al. (2005). Congenital cytomegalovirus infection: association between virus burden in infancy and hearing loss. Journal of Pediatrics, 146(6), 817–823.

    Article  PubMed  Google Scholar 

  28. Korzeniewski, S. J., Grigorescu, V., Copeland, G., Gu, G., Thoburn, K. K., Rogers, J. D., et al. (2010). Methodological innovations in data gathering: newborn screening linkage with live births records, Michigan, 1/2007–3/2008. Maternal and Child Health Journal, 14(3), 360–364.

    Article  PubMed  CAS  Google Scholar 

  29. Staras, S. A., Dollard, S. C., Radford, K. W., Flanders, W. D., Pass, R. F., & Cannon, M. J. (2006). Seroprevalence of cytomegalovirus infection in the United States, 1988–1994. Clinical Infectious Diseases, 43(9), 1143–1151.

    Article  PubMed  Google Scholar 

  30. McDade, T. W., Williams, S., & Snodgrass, J. J. (2007). What a drop can do: Dried blood spots as a minimally invasive method for integrating biomarkers into population-based research. Demography, 44(4), 899–925.

    Article  PubMed  Google Scholar 

  31. Mei, J. V., Alexander, J. R., Adam, B. W., & Hannon, W. H. (2001). Use of filter paper for the collection and analysis of human whole blood specimens. Journal of Nutrition, 131(5), 1631S–1636S.

    PubMed  CAS  Google Scholar 

  32. Atkinson, C., Walter, S., Sharland, M., Tookey, P., Luck, S., Peckham, C., et al. (2009). Use of stored dried blood spots for retrospective diagnosis of congenital CMV. Journal of Medical Virology, 81(8), 1394–1398.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Robert Hood, William Hendley, Charina Bialo, Joseph Chiaro, Anita Lewis, Patti Ragan, Laura Connell, John Middaugh, Joann Steele, Kay Smith-Akin, Lori Westphal, Diana Bensyl, and Maria McLeod for their important contributions in various aspects of the study or for critical review of the manuscript. This public health surveillance activity was funded by the Centers for Disease Control and Prevention. All opinions expressed are those of the authors and not of the funding agency.

Conflict of interest

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Florida Department of Health.

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Authors and Affiliations

  1. LBJ Tropical Medical Center, PO Box LBJ, Pago Pago, American Samoa, CA, 96799, USA

    John M. DePasquale

  2. Florida Department of Health, 4052 Bald Cyprus Way, Bin A-12, Tallahassee, FL, 32399-1720, USA

    Karen Freeman, Samantha Rivers & Richard Hopkins

  3. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA

    Minal M. Amin, Sohyun Park & Michael J. Cannon

  4. Florida Department of Health, 1217 Pearl St., Jacksonville, FL, 32202, USA

    Bonifacio Dy

  5. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G-18, Atlanta, GA, 30333, USA

    Sheila C. Dollard

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  1. John M. DePasquale
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  2. Karen Freeman
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  3. Minal M. Amin
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  9. Sheila C. Dollard
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Correspondence to Sheila C. Dollard.

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DePasquale, J.M., Freeman, K., Amin, M.M. et al. Efficient Linking of Birth Certificate and Newborn Screening Databases for Laboratory Investigation of Congenital Cytomegalovirus Infection and Preterm Birth: Florida, 2008. Matern Child Health J 16, 486–494 (2012). https://doi.org/10.1007/s10995-010-0740-2

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  • DOI: https://doi.org/10.1007/s10995-010-0740-2

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