Congenital cytomegalovirus infection is associated with high maternal socio‐economic status and corresponding low maternal cytomegalovirus seropositivity

Aims Human cytomegalovirus ( CMV ) is the leading infectious cause of congenital infection in developed countries. Globally, CMV seropositivity has been associated with low socio‐economic status ( SES ); however, A ustralian data are lacking. Therefore, we examined the association between SES and CMV seroprevalence in children and pregnant women. Methods Three groups were examined: 1, a prospective cohort of A ustralian children aged 0–15 years ( n = 220); 2, a clinic‐based sample of pregnant women ( n = 778); and 3, a case series of infants and children ( n = 219) with symptomatic congenital CMV infection. SES was determined using a postcode‐based score from the Australian Bureau of Statistics.Group 1 was recruited from endocrinology clinics and follow‐up at P rince of W ales H ospital and C hildren's H ospital at W estmead. Group 2 was recruited at the R oyal H ospital for W omen. Congenitally infected infants were identified through the A ustralian Paediatric Surveillance Unit. Results CMV seroprevalence among all children was 20% (95% confidence interval ( CI ) 15–25%), and there was no association with SES ( P = 0.58). Seroprevalence among pregnant women was 57% (53–60%), and higher rates of CMV seropositivity were associated with lower SES ( P < 0.001). More congenital CMV cases were reported in the highest socio‐economic groups (55%) than the lowest (9%) ( P < 0.001). Conclusions A marked socio‐economic gradient in CMV seroprevalence is evident in Australian pregnant women and cases of congenital CMV but not in unselected A ustralian children. These findings highlight the importance of a community‐wide approach to CMV awareness and the potential for hygienic measures to reduce the burden of congenital CMV in A ustralia.