Seroprevalence of Cytomegalovirus among Women of Reproductive Age in Iran: A Systematic Review and Meta-Analysis

  • Maedeh SHARGHI Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
  • Hadis MUSAVI Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  • Shabnam MALEKPOUR MANSURKHANI Department of Biology, School of Sciences, Shiraz University, Shiraz, Iran
  • Wesam KOOTI Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
  • Masoud BEHZADIFAR Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  • Hadis ASHRAFI-ZADEH Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Milad AZAMI Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
  • Roonak SHAHOOEI Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  • Hajar KASHEFI Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
  • Leila JOUYBARI Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Keywords: Cytomegalovirus, Pregnancy, Epidemiology, Prevalence, Iran, Systematic review, Meta-analysis


Background: Human cytomegalovirus (CMV) able to cause infection for an entire lifetime. This systematic review and meta-analysis was conducted to determine seroprevalence of CMV among women of reproductive age in Iran. Methods: English and Persian databases such as Web of Science (WOS), PubMed, Scopus, Cochrane Library, SID, Iran doc, Iran Medex, Magiran, and Medlib were searched (from 2008 to 2017) accurately using the Results: Results of 15 studies with total samples of 5253 persons from 2008 to 2017 were combined and meta-analyzed. The pooled prevalence rate of IgG among women was estimated 90% (95% CI: 87-93%). The highest prevalence rate of IgG was in Tehran, Rasht, Mashhad and Yasoj, all 100% (95% CI: 100-100%), and the lowest prevalence was in Jahrom 0.62% (95% CI: 53-71%). The overall prevalence rate of IgM among women was estimated at 0.06% (95% CI: 0.03-0.13%). The highest prevalence rate of IgM was in Kerman 0.34% (95% CI: 0.29-0.39%) and Mashhad 0.25% (95% CI: 0.2-0.31%), and the lowest prevalence was in Yasoj 0% (95% CI: 0.00%-0.00%) Conclusion: The prevalence of immunity in Iran, is satisfactory. Nevertheless, to maintain and increase the level of immunity across the country, it is necessary to routinely screen the women of reproductive ages across the country.


1. Cannon MJ (2009). Congenital cytomegalovirus (CMV) epidemiology and awareness. J Clin Virol, 46 Suppl 4:S6-10.
2. Picone O, Vauloup‐Fellous C, Cordier AG, et al (2009). A 2‐year study on cytomegalovirus infection during pregnancy in a French hospital. BJOG, 116(6):818-23.
3. Hassan J, O’Neill D, Honari B et al (2016). Cytomegalovirus Infection in Ireland: Seroprevalence, HLA Class I Alleles, and Implications. Medicine (Baltimore), 95(6) e2735.
4. Enders G, Daiminger A, Lindemann L et al (2012). Cytomegalovirus (CMV) seroprevalence in pregnant women, bone marrow donors and adolescents in Germany, 1996–2010. Med Microbiol Immunol, 201(3):303-09.
5. Pembrey L, Raynor P, Griffiths P et al (2013). Seroprevalence of cytomegalovirus, Epstein Barr virus and varicella zoster virus among pregnant women in Bradford: a cohort study. PloS One, 8(11):e81881.
6. Abu-Madi MA, Behnke JM, Dabritz HA (2010). Toxoplasma gondii seropositivity and co-infection with TORCH pathogens in high-risk patients from Qatar. Am J Trop Med Hyg, 82(4):626-33.
7. Spano L, Gatti J, Nascimento JP, Leite J (2004). Prevalence of human cytomegalovirus infection in pregnant and non-pregnant women. J Infect, 48(3):213-20.
8. Leung AK, Sauve RS, Davies HD (2003). Congenital cytomegalovirus infection. J Natl Med Assoc, 95(3):213-8.
9. Lazzarotto T, Gabrielli L, Lanari M et al (2004). Congenital cytomegalovirus infection: recent advances in the diagnosis of maternal infection. Hum Immunol, 65(5):410-5.
10. Torpy JM, Burke AE, Glass RM (2010). Cytomegalovirus. JAMA, 303(14):1440.
11. Arabzadeh SAM, Mosavat SA, Eftekhari N (2007). Seroepidemiology of human cytomegalovirus in pregnant women and their neonates in Kerman city during 2005. J Kerman Univ Med Sci, 14(4):279-88.
12. Kakru M, Shaheen R, Nazir A (2004). Seroprevalence of Cytomegalovirus (CMV) in Kashmir valley-a preliminary study. JK-Practitioner, 11(4):261-62.
13. Kenneson A, Cannon MJ (2007). Review and meta‐analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol, 17(4):253-76.
14. Nigro G, Adler SP (2011). Cytomegalovirus infections during pregnancy. Curr Opin Obstet Gynecol, 23(2):123-28.
15. Fowler KB, Stagno S, Pass RF (2003). Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA, 289(8):1008-11.
16. Odland JØ, Sergejeva IV, Ivaneev MD et al (2001). Seropositivity of cytomegalovirus, parvovirus and rubella in pregnant women and recurrent aborters in Leningrad County, Russia. Acta Obstet Gynecol Scand, 80(11):1025-29.
17. DerSimonian R, Larid N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3): 177-88.
18. Higgins JP, Thompson SG (2002). Quantifying heterogeneity in a meta-analysis. Stat Med, 21(11):1539-58.
19. Egger M, Davey Smith G, Schneider M, Minder C (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-34.
20. Zhang S, Hu L, Chen J et al (2014). Cytomegalovirus seroprevalence in pregnant women and association with adverse pregnancy/neonatal outcomes in Jiangsu Province, China. PloS One, 9(9):e107645.
21. Abduljaleel A, Adewunmi AA, Wright KO et al (2011). Seroprevalence of cytomegalovirus antibodies amongst normal pregnant women in Nigeria.
Int J Women's Health, 3(1):423-28.
22. Hamdan HZ, Abdelbagi IE, Nasser NM, Adam I (2011). Seroprevalence of cytomegalovirus and rubella among pregnant women in western Sudan. Virol J, 8:217.
23. Alvarado-Esquivel C, Hernández-Tinoco J, Sánchez-Anguiano LF et al (2014). Seroepidemiology of cytomegalovirus infection in pregnant women in Durango City, Mexico. BMC Infect Dis, 14: 484.
24. Colugnati FA, Staras SA, Dollard SC, Cannon MJ (2007). Incidence of cytomegalovirus infection among the general population and pregnant women in the United States. BMC Infect Dis, 7:71.
25. Sifakis S, Ergazaki M, Sourvinos G, et al (1998). Evaluation of Parvo B19, CMV and HPV viruses in human aborted material using the polymerase chain reaction technique. Eur J Obstet Gynecol Reprod Biol, 76(2):169-73.
26. Al-Khafaji AH, Al-Zubaidi KI (2010). Seroprevalence of cytomegalovirus infection among aborted women in Thi-Qar Governorate. DQ Sci J, 2:20-26.
27. Mohammadi F, Nouri Gorji M, Rasti F et al (2016). Seroprevalence of Cytomegalovirus Infection in the Students of Babol University of Medical Sciences (2011-2014). NHJ, 1(1):7-11.
28. Bagheri L, Mokhtarian H, Sarshar N, Ghahramani M (2012). Seroepidemiology of Cytomegalovirus Infection during Pregnancy in Gonabad, East of Iran: A Cross-Sectional Study. J Res Health Sci,12(1):38-44.
29. Ebadi P, Yaghobi R, Eftekhar F, Bagheri K (2011). Seroprevalence of CMV and Rubella in Women with Recurrent Spontaneous Abortion in Comparison with Normal Delivery. J Fasa Univ Med Sci, 1(3):136-41.
30. Janan A, Honormand HR, Amirmozafari N, et al (2014). Distribution of Cytomegalovirus Infection in Spontaneous Abortion. Iran J Obstetr Gynecol Infertil, 17(102): 12-19.
31. Janan A, Honarmand H, Amirmozafari N et al (2013). Study on Seroprevalence of Cytomegalovirus in Pregnant Women and the Association of Cytomegalovirus Seropositivity to Spontaneous Abortion. J Mazandran Univ Med Sci, 23(105): 36-42.
32. Monavari SH, Keyvani H, Kiasari BA et al (2012). Detection of cytomegalovirus (CMV) antibodies or DNA sequences from ostensibly healthy Iranian mothers and their neonates. Int J Med Med Sci, 4(8):155-59.
33. Ghasemi FS, Rasti S, Piroozmand A et al (2015). Comparison of the Frequency of anti-CMV, - Rubella and -HSV antibodies in women with spontaneous abortion and normal delivery. Feyz, 19(1):86-92.
34. Ilami O, Tajbakhsh S, Mousavizadeh S et al (2015). Seroprevalance Determination of Cytomegalovirus Infection in Women in Their Reproductive Age Referred to Shahid Mofateh Clinic of Yasuj, Iran, in 2013. Armaghane Danesh, 20(4):309-17.
35. Delfan-Beiranvand M, Sheikhian A, Birjandi M, Fazeli M (2011). Seroprevalence of Cytomegalovirus Infection in Pregnant Women Referred to Health Care Center of Khorramabad. Iran J Virol, 5(4):11-16.
36. Rajaii M, Pourhassan A (2008). Evaluation of immunity against CMV in Azarbaijan female population. Clin Infect Dis, 3(3): 143-148.
37. Rajaii M, Nezami N, Pourhassan A et al (2009). Serological ELISA test (IgM & IgG) for prospective Study of cytomegalovirus (CMV) infection in pregnant women. Iran J Public Health, 38(3):109-12.
38. Barazesh A, Zandi K, Hadavand F, et al (2014). Seroepidemiology of Rubella, Cytomegalovirus, Herpes simplex & Varicella zoster virus in college women of Bushehr. Iran South Med J, 16(6):459-66.
39. Erfanianahmadpoor M, Nasiri R, Vakili R, Hassannia T (2014). Seroprevalence, transmission, and associated factors of specific antibodies against cytomegalovirus among pregnant women and their infants in a regional study. Saudi Med J, 35(4):360-64.
40. Arabpour M, Kaviyanee K, Jankhah A, Yaghobi R (2007). Human cytomegalovirus infection in women of childbearing age, Fars Province: a population-based cohort study. Mal J Microbiol, 3(2): 23-28.
How to Cite
SHARGHI M, MUSAVI H, MALEKPOUR MANSURKHANI S, KOOTI W, BEHZADIFAR M, ASHRAFI-ZADEH H, AZAMI M, SHAHOOEI R, KASHEFI H, JOUYBARI L. Seroprevalence of Cytomegalovirus among Women of Reproductive Age in Iran: A Systematic Review and Meta-Analysis. Iran J Public Health. 48(2):206-216.
Review Article(s)