Implementation of antenatal cytomegalovirus prevention education and targeted first-trimester screening: feasibility, acceptability and psychological outcomes

Implementation of antenatal cytomegalovirus prevention education and targeted first-trimester screening: feasibility, acceptability and psychological outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Implementation of antenatal cytomegalovirus prevention education and targeted first-trimester screening: feasibility, acceptability and psychological outcomes Tanya Tripathi, Jotara Watson, Natasha E Holmes, Jacqui McCoy, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7669354/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background Congenital cytomegalovirus (CMV) is a leading infectious cause of childhood disability, yet antenatal screening is not recommended in most countries. Implementation of CMV prevention education and early pregnancy screening has the potential to enable timely identification of primary infection and improve clinical management. This study evaluated the feasibility, acceptability and psychological impact of a structured CMV education and targeted serological screening pathway in early pregnancy. Methods We conducted a prospective implementation study at a tertiary maternity service in Australia. Pregnant women presenting for first-trimester care were offered CMV prevention education and serological screening using a two-step approach, consisting of initial serostatus assessment and repeat testing in seronegative women. Feasibility outcomes included uptake of education and screening, and participant-reported acceptability. Psychological impact was assessed using validated measures of anxiety at baseline and follow-up time points in second trimester and postpartum. Results The majority of eligible women accepted CMV education and screening, demonstrating high feasibility of integrating the pathway into routine antenatal care. Among participants, 92% (95% CI: 82%–97%) completed repeat CMV serology within the recommended gestational window. Participants reported high levels of satisfaction with the information provided and supported the availability of CMV screening in pregnancy. There was no evidence of a sustained increase in anxiety following screening, including among women identified as being at increased risk who underwent repeat testing. No maternal seroconversions were observed during the study period (0.0%; 95% CI: 0.0%–6.6%). Conclusion Implementation of antenatal CMV prevention education and targeted first-trimester screening was feasible, acceptable to pregnant women, and not associated with adverse psychological effects. These findings support the safety and acceptability of structured CMV screening pathways and provide important implementation evidence to inform future policy, guideline development, and larger effectiveness studies evaluating antenatal CMV screening. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12623000710628, retrospectively registered on 04 July 2023. Obstetrics & Gynecology Infectious Diseases congenital cytomegalovirus antenatal screening feasibility Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryFileI.pdf Supplementary File 1 SupplementaryFileII.pdf Supplementary File 2 SupplementaryFileII.pdf Supplementary File 2 SupplementaryFileIV.pdf Supplementary File 4 Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7669354","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":521198626,"identity":"1219426c-9263-4230-ad12-a17a251fd9df","order_by":0,"name":"Tanya Tripathi","email":"","orcid":"https://orcid.org/0000-0002-7490-6310","institution":"The University of Melbourne","correspondingAuthor":false,"prefix":"","firstName":"Tanya","middleName":"","lastName":"Tripathi","suffix":""},{"id":521198627,"identity":"4c647e74-eab0-4f32-bb78-57211922721b","order_by":1,"name":"Jotara Watson","email":"","orcid":"","institution":"The University of 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cytomegalovirus (CMV) is a leading infectious cause of childhood disability, yet antenatal screening is not recommended in most countries. Implementation of CMV prevention education and early pregnancy screening has the potential to enable timely identification of primary infection and improve clinical management. This study evaluated the feasibility, acceptability and psychological impact of a structured CMV education and targeted serological screening pathway in early pregnancy.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a prospective implementation study at a tertiary maternity service in Australia. Pregnant women presenting for first-trimester care were offered CMV prevention education and serological screening using a two-step approach, consisting of initial serostatus assessment and repeat testing in seronegative women. Feasibility outcomes included uptake of education and screening, and participant-reported acceptability. Psychological impact was assessed using validated measures of anxiety at baseline and follow-up time points in second trimester and postpartum.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe majority of eligible women accepted CMV education and screening, demonstrating high feasibility of integrating the pathway into routine antenatal care. Among participants, 92% (95% CI: 82%\u0026ndash;97%) completed repeat CMV serology within the recommended gestational window. Participants reported high levels of satisfaction with the information provided and supported the availability of CMV screening in pregnancy. There was no evidence of a sustained increase in anxiety following screening, including among women identified as being at increased risk who underwent repeat testing. No maternal seroconversions were observed during the study period (0.0%; 95% CI: 0.0%\u0026ndash;6.6%).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eImplementation of antenatal CMV prevention education and targeted first-trimester screening was feasible, acceptable to pregnant women, and not associated with adverse psychological effects. These findings support the safety and acceptability of structured CMV screening pathways and provide important implementation evidence to inform future policy, guideline development, and larger effectiveness studies evaluating antenatal CMV screening.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eAustralian New Zealand Clinical Trials Registry, ACTRN12623000710628, retrospectively registered on 04 July 2023.\u003c/p\u003e","manuscriptTitle":"Implementation of antenatal cytomegalovirus prevention education and targeted first-trimester screening: feasibility, acceptability and psychological outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2026-04-22 16:55:59","doi":"10.21203/rs.3.rs-7669354/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-09-26 15:06:37","doi":"10.21203/rs.3.rs-7669354/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9f84c19e-7e79-4547-a33d-db4094b37ee8","owner":[],"postedDate":"April 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":66611893,"name":"Obstetrics \u0026 Gynecology"},{"id":66611894,"name":"Infectious Diseases"}],"tags":[],"updatedAt":"2025-09-26T15:06:37+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-22 16:55:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-7669354","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7669354","identity":"rs-7669354","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}