Protecting the Health of Pregnant Women

Primary Human Cytomegalovirus (HCMV) Infection in Pregnancy by Dr. med. Horst Buxmann, Prof. Dr. med. Dr. rer. nat. Klaus Hamprecht, Prof. Dr. med. Matthias Meyer-Wittkopf, and em. Prof. Dr. med. Klaus Friese in issue 4/2017

As an occupational physician, I thank Buxmann et al. for their review article, which excellently summarized what is currently known about cytomegalovirus infection (1). When pregnant women are counselled in the workplace, they receive far too little information about infection pathways of cytomegalovirus (CMV) and opportunities for preventing infection.

For CMV infections in the workplace setting, however, meaningful studies for the German speaking region are lacking. Because of this lack of data, the recommendations of the statutory maternity protection authorities with regard to employment restrictions for expectant mothers are heterogeneous. Some federal states have banned all pregnant women who are CMV seronegative from contact with children younger than 3 years, which means one in two pregnant women in this setting.

Solid supporting data are lacking not only at the health political level but also at the corporate level. In order to gain initial insights into the risk of CMV for daycare workers, CMV serostatus and risk factors of pregnant nursery workers from children‘s day care centers in Hamburg (n = 509), collected between 2010 and 2013, were compared with data from women donating blood for the first time (n = 14 358). The entire group of daycare workers had a higher seroprevalence (SP) depending on age than the blood donors, but there was no difference between the teachers and the subgroup of blood donors with a history of pregnancy and living in urban areas (SP 54.6 versus 53.9 %; odds ratio 0.9; 95% confidence interval [0.8; 1.2] (2, 3).

The results confirm those from studies from other European countries, which found a CMV infection risk that was comparable to infection risks in the private sphere—except for the first two years in work (4). CMV seropositive pregnant women working in exposed areas such as neonatology, obstetrics, children‘s day cares, oncology, and intensive care will have to be made aware of targeted hygiene measures on a continuing basis. Current longitudinal studies of the CMV infection risk in the workplace and of occupational prevention strategies are needed to provide competent advice.

DOI: 10.3238/arztebl.2017.0504a

Dr. med. univ. Johanna Stranzinger

Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege

Grundlagen der Prävention und Rehabilitation

Fachbereich Arbeitsmedizin

Hamburg

Conflict of interest statement

The author declares that no conflict of interest exists.

References

1. Buxmann H, Hamprecht K, Meyer-Wittkopf M, Friese K: Primary human cytomegalovirus (HCMV) infection in pregnancy. Dtsch Arztebl Int 2017; 114: 45–52

2. Stranzinger J, Kindel J, Henning M, Wendeler D, Nienhaus A: Prevalence of CMV infection among staff in a metropolitan childrens´s hospital—occupational health screening findings. GMS Hyg Infect Control 2016; 11: Doc20

3. Stranzinger J, Kozak A, Schilgen B, et al.: Are female daycare workers at greater risk of cytomegalovirus infection? A secondary data analysis of CMV seroprevalence between 2010 and 2013 in Hamburg, Germany, GMS Hyg Infect Control 2016; 11: Doc0

4. Stelma FF, Smismans A, Goossens VJ, Bruggeman CA, Hoebe CJ: Occupational risk of human cytomegalovirus and parvovirus B19 infection in female day care personal in the Netherlands, a study based on seroprevalence. Eur J Clin Microbiol Infect Dis 2009; 28: 393–7