Pregnancy, Infectious Disease Antibody Profile (CMV, Parvovirus, Toxoplasma)

CMV: Routine screening of pregnant people for CMV is not recommended by current guidelines. Maternal CMV IgM antibody has limited clinical utility in differentiating primary from recurrent infection. An IgG-positive, IgM-negative result typically indicates past infection; however, IgG avidity testing, to determine the time since primary infection, should be considered if clinically warranted. An IgG-positive, IgM-positive result suggests recent primary infection and IgG avidity testing is recommended to determine the time since primary infection. An IgG-negative, IgM-positive result suggests very recent infection and the patient should be followed to document seroconversion. An IgG-negative, IgM-negative result indicates susceptibility to infection.

Parvovirus B19: Routine screening of pregnant people for parvovirus B19 is not recommended by current guidelines. Testing should be performed for those patients with symptoms consistent with parvovirus B19 infection or for those with exposure to suspected or confirmed acute infections. Women who are negative for both IgG and IgM are susceptible to parvovirus B19 infection, and serologic testing should be repeated in four weeks.

Toxoplasma: Routine screening of pregnant people for toxoplasmosis is not recommended by current guidelines and should be limited to immunosuppressed or HIV-positive individuals. An IgG-positive, IgM-negative result typically indicates past infection. Toxoplasma IgM may persist for many months or years after acute infection, and false-positive test results are common. IgG-negative, IgM-positive results suggest possible very recent infection and should be followed to document seroconversion. An IgG-positive, IgM-positive result suggests recent primary infection, and IgG avidity testing is recommended to determine the time since primary infection.