Prevalence of serological markers IgG and IgM antibodies against cytomegalovirus among aborted women in Lahj Governorate, Yemen

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M. Gubran, Alaa Hatem Othman Qasim, Eglal Yones Abdulwali Ali, and 10 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7743994/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: CMV infection is one of the commonest viral infections that is related to abortion among pregnant women. Objectives: This study aimed to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies among aborted women in Lahj Governorate, Yemen, and to determine possible associated factors that contribute to CMV infection among those women. Methods: An analytical cross-sectional study was conducted on 110 aborted women; five ml of blood was collected from women, sera were separated, and anti-CMV IgG and IgM were determined using a cobas® e 411 analyzer that is based on ECLIA. The data was entered and then analyzed using SPSS. Results: The overall prevalence of IgG and IgM antibodies to CMV infections was 80.9% and 7.3%, respectively. High-income aborted women had a statistically significant association with positive anti-CMV IgG antibodies (p=0.019). The present data detected that anti-CMV IgG and IgM antibodies were high at 81.8% and 12.1% among women who had recurrent abortion, respectively. The significant associations were only noticed between anti-CMV IgG antibodies and period of marriage, number of pregnancies (2-3 times), and exposure to blood transfusion (p=0.01, 0.030, and 0.047), respectively. The highest IgG positivity rate was 83.3%, observed among women who had 2–3 live children, while the highest anti-CMV IgM positivity rate was 10%, reported among women who had no live child, but these results were not statistically significant. Conclusions: The seroprevalence of CMV IgG was higher compared to IgM in Lahj, Yemen. The CMV antibodies were high among women with recurrent abortions. Only positive IgG against CMV was significantly associated with high socioeconomic status, a period of marriage of 7-9 years, pregnancies 2-3 times among aborted women, and previous exposure to blood transfusion. The highest IgG positivity rate was observed among women who had 2–3 live children, while the anti-CMV IgM was high among those who had no live child without any significant association. Seroprevalence CMV aborted women abortion IgG IgM Lahj Yemen Figures Figure 1 Figure 2 Introduction The cytomegalovirus (CMV) infection is one of the commonest viral infections that cause miscarriage (abortion) among pregnant women [ 1 ]. CMV is a member of Herpesviridae [ 2 ]. This virus is the leading cause of stillbirth and congenital abnormalities among fetuses and newborns, respectively [ 3 ]. The CMV infection may occur in three forms: primary, recurrent, or reactivation of latent infection [ 4 ]. The infection with CMV is based on the immune status of an individual, where the healthy individuals may exhibit no symptoms (asymptomatic), but severe life-threatening complications occur among pregnant women, immunocompromised individuals, recipients of organs (organ transplant), those receiving immunosuppressive drugs, and patients with immunodeficiency, such as acquired immunodeficiency syndrome (AIDS) [ 5 , 6 ]. The virus can be shed in most body fluids and secretions, including saliva, tears, breast milk, and genital tract secretions [ 7 , 8 ]. The fetus can get CMV infection from an infected mother through the placenta [ 9 ] and the newborn through breastfeeding and during delivery (birth canal) [ 10 ]. Sexual contact, kissing, unscreened transfusion of contaminated blood or blood products, and organ transplants are the common routes of transmission between adults [ 11 , 12 ]. Globally, the prevalence of CMV antibodies among aborted women varies, where immunoglobulin G (IgG) antibodies ranged from 4.1% to 100% versus 0% to 93% immunoglobulin M (IgM) antibodies [ 13 , 14 , 15 , 16 ]. In Yemen, four studies were conducted among Yemeni women who aborted to estimate the seropositive IgG and IgM against CMV in four different governorates, where the prevalence of IgG and IgM antibodies was 77.6% and 83.3% in Aden [ 2 ], 99% and 3.8% in Abyan [ 17 ], 98.7% and 7.33% in Ibb [ 18 ], and 99.3% and 3.7% in Dhamar, respectively [ 19 ]. Understanding the magnitude of the CMV infections among aborted women is important for exploring the epidemiology and applying the appropriate preventive measures for controlling the virus and treatment strategies for infected women, thereby reducing the risk of transplacental transmission and burden of abortion and congenital disorders. There was no single report about the seroprevalence of CMV among aborted women in Lahj Governorate. Therefore, our study was conducted for the first time in this governorate, where it aimed to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies among aborted women in Lahj Governorate, Yemen, and to determine possible associated factors that contribute to CMV infection among those women. Subjects and Methods Study area and design This study was analytical cross-sectional conducted in Lahj Governorate, Yemen, to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies and risk factors associated with CMV infection among aborted women from February 1, to June 15, 2025. This study is a type of observational studies in which the collection and analysis of data study group at a single point in time without follow up as well as both outcomes and exposures of study group are determined at the same time [ 20 ]. Sample size The sample size of women with a previous history of abortion was calculated after obtaining the prevalence of CMV among aborted women from a study conducted in Abyan, Yemen, where the rate was 99% (17). The sample size was calculated based on Stephen Thompson's formula: \(\:N=\frac{{\varvec{Z}}^{2}\varvec{P}(1-\varvec{P})}{{\varvec{d}}^{2}}\) N = expected minimum sample size, Z = standard, corresponding to 95% confidence (1.96), P = the % estimated prevalence at 99% (0.99), and D = maximum likely error taken as 5% [ 21 ]. N \(\:=\frac{{\varvec{Z}}^{2}\varvec{P}(1-\varvec{P})}{{\varvec{d}}^{2}}=\frac{{(1.96)}^{2}\times\:98.7\varvec{\%}(1-9.17\varvec{\%})}{{\left(5\varvec{\%}\right)}^{2}}=\) 20 women. During collection of data and blood specimens, 110 women were enrolled in this study, which was more than the sample size because all of these women came at the same time and met the criteria for inclusion in the study. Data collection Data were collected by interviewing the participants after obtaining a signed informed consent form and using a previously designed questionnaire that was modified to be available for our study. It included age, education level, residence, occupation, and economic status. It also includes clinical history data such as primary abortion, recurrent abortion, and number of abortions; trimester of abortion for those who had recurrent abortion; period of marriage; number of pregnancies; and the live birth number. The presence of symptoms related to infection among women is noted, and two commonly important risk factors include exposing women to blood transfusion and use of corticosteroid drugs [ 2 , 17 , 18 ]. The women with a history of abortion were included in our study. Those women who were not exposed to abortion, children, or single women and underage girls were excluded from this study. Laboratory procedures Five ml of blood was collected from all the women using plain vacutainer tubes that were transported to the laboratory of Tour Sina Hospital in Saber City, Lahj. The sera were separated from clotted blood using a centrifuge, and the unprocessed sera were stored at − 80°C till processing. The specific anti-CMV IgG and IgM antibodies were determined using a commercially fully automated cobas® e 411 analyzer (Roche Diagnostics Germany) that was based on electrochemiluminescence immunoassay (ECLIA) because its sensitivity and specificity were greater than 97%. The calibration of the analyzer is done according to the instructions of the manufacturer before testing the sera using provided standards and controls. [ 22 ]. Data analysis The data were entered, then analyzed using the Statistical Package for the Social Sciences (SPSS®) software (Version 26). The ages of aborted women were abnormally distributed, so the median values and interquartile range (IQR) were determined. Almost all the data were qualitative. Therefore, they were represented as numbers and percentages. The significant associations between different variables are determined by using the chi-square (χ²) test to calculate the probability value (p-value). A p-value equal to or less than 0.05 suggests a statistically significant result. Results The aborted women (n = 110) included in our study had a median age of 26 (IQR = 7) years. According to the sociodemographic characteristics of women, the majority of women were 36 (32.7%) in the age group 26–29 years, 61 (55.5%) had a secondary school education level, 76 (69.1%) were from urban areas, 72 (65.5%) had a medium income, and 74 (67.3%) were housewives (Table 1 ). Table 1 The sociodemographic characteristics of 110 aborted women in Lahj, Yemen. Variable Number Parentage % Age (years) 29 21 19.1 Education level Illiterate 7 6.4 Primary school 22 20.0 Secondary school 61 55.5 University 20 18.2 Residence Rural 34 30.9 Urban 76 69.1 Socioeconomic status (income) Low 25 22.7 Medium 72 65.5 High 13 11.8 Occupation Housewife 74 67.3 Daily work 8 7.3 Private work 18 16.4 Employment 10 9.1 The overall prevalence of IgG and IgM antibodies to CMV infections was 89 (80.9%) and 8 (7.3%), respectively (Fig. 1 ). The highest IgG rates were 20 (87%) among women in the age group 22–25 years, 52 (85.2%) among those with a secondary school education, 64 (84.2%) in those from urban areas, 13 (100%) in those with a high income, and 8 (100%) among women who work daily. The prevalence of IgM was also high: 4 (11.1%) in group 26-29-year-old women, 1 (14.3%) illiterate, 6 (7.9%) urban, 2 (15.4%) with high income, and 7 (9.5%) housewives. With the exception of high-income aborted women (p = 0.019), all these results were not statistically significant (Table 2 ). The present data detected that anti-CMV IgG and IgM antibodies were high at 27 (81.8%) and 4 (12.1%) among women who had recurrent abortion,respectively (Fig. 2 ). Table 2 Prevalence of CMV serological markers IgG and IgM among aborted women related to their sociodemographic status in Lahj, Yemen Category IgG positive P-value IgM positive P-value No. % No. % Age groups/years 29 (n = 21) 17 81.0 0 0.0 Educational level Illiterate (n = 7) 4 57.1 0.288 1 14.3 0.845 Primary (n = 22) 18 81.8 2 9.1 Secondary (n = 61) 52 85.2 4 6.6 University (n = 20) 15 75.0 1 5.0 Residence Ruler (n = 34) 25 73.5 0.146 2 5.9 0.527 Urban(n = 76) 64 84.2 6 7.9 Socioeconomic status Low (n = 25) 17 68.0 0.019 2 8.0 0.449 Medium (n = 72) 59 81.9 4 5.6 High (n = 13) 13 100.0 2 15.4 Occupation Housewife (n = 74) 60 81.1 0.242 7 9.5 0.350 Daily (n = 8) 8 100.0 0 0.0 Private (n = 18) 14 77.8 1 5.6 Employment (n = 10) 7 70.0 0 0.0 As regards the highest rates of CMV with serological markers IgG and IgM among aborted women according to the number of recurrent abortions, they were 18 (85.7%) and 4 (19%) among women who were exposed to abortion two times and 31 (86.1%) and 5 (8.2%) among women aborted in the second and first trimesters, 19 (100%) and 3 (13%) among women whose period of marriage was 7–9 years and < 2 years, and 11 (100%) and 1 (9.1%) among women with 2–3 pregnancies and 15 (83.3%) and 8 (10%) among women who had 1–2 and no live children, respectively (Table 3 ). The significant associations were only noticed between anti-CMV IgG antibodies and period of marriage and number of pregnancies (p = 0.01 and 0.030), respectively. Table 3 Prevalence of CMV serological markers IgG and IgM among aborted women according to number of recurrent abortions and trimesters of abortion, period of marriage, number of pregnancies, and live births in Lahj, Yemen Category IgG positive P-value IgM positive P-value No. % No. % Number recurrent Abortion Twice (n = 21) 18 85.7 0.678 4 19.0 0.140 Third (n = 9) 7 77.8 0 0.0 More than 3 (n = 3) 2 66.7 0 0.0 Trimesters 1st trimester (n = 61) 47 77.0 0.513 5 8.2 0.883 2nd trimester (n = 36) 31 86.1 2 5.6 3rd trimester (n = 13) 11 84.6 1 7.7 Period of marriage 9 years (n = 20) 14 70.0 0 0.0 Number of pregnancies 3 (n = 10) 6 60.0 0 0.0 Number of live births No live birth (n = 80) 65 81.2 0.841 8 10.0 0.070 1–2 children (n = 18) 15 83.3 0 0.0 < 2 children (n = 12) 9 75.0 0 0.0 Regarding the symptoms and the related risk factors, the rates of IgG and IgM antibodies were 9 (81.8%) and 2 (18.2%) among women who had skin rash and 3 (75.0%) and 0.0% among women who had had lymphadenopathies, respectively. About 46 (88.5%) and 5 (9.6%) of women who received blood transfusions and 9 (75%) and 2 (16.7%) who used corticosteroids had positive IgG and IgM antibodies against CMV, respectively. Only a positive IgG result was significantly associated with exposure to blood transfusion (p = 0.047) (Table 4 ). Table 4 Prevalence of CMV serological markers IgG and IgM among aborted women according to symptoms and associated risk factors in Lahj, Yemen. Category anti-CMV IgG anti-CMV IgM No % P-value No % P-value Symptoms Skin rash Yes(n = 11) 9 81.8 0.649 2 18.2 0.182 No(n = 99) 80 80.8 6 6.1 Lymphadenopathy Yes(n = 4) 3 75.0 0.577 0 0.0 0.736 No(n = 106) 86 81.1 8 7.5 Risk factors Blood transfusion Yes(n = 52) 46 88.5 0.047 5 9.6 0.299 No (n = 58) 43 74.1 3 5.2 Use corticosteroid Yes(n = 12) 9 75,0 0.411 2 16.7 0.211 No(n = 98) 80 81.6 6 6.1 Discussion The seroprevalence of CMV infections among aborted women in the Lahj governorate of Yemen was determined for the first time in the current study, where the seroprevalence of IgG antibodies against CMV was 80.9%, indicating that most aborted women were previously exposed to CMV. A study from Bangladesh revealed that 82% of women with prior miscarriages had positive anti-CMV IgG [ 23 ]. Our finding was lower than that reported by several previous studies, such as in Yemen (99.3%, 99%, and 98.7%). [ 17 , 18 , 19 ], Iraq (98%, 96.3%, 92.9%, 92%, 89%, 85%) [ 1 , 16 , 24 , 25 , 26 ], Tanzania (93.33%) [ 27 ], India (92.50%) [ 28 ], Iran (90.6%) [ 29 ], Niger (85.7%) [ 30 ], and Sudan (97.8%) [ 31 ]. Research from Iraq recorded the highest IgG rates, where all 100% of studied aborted women had seropositive anti-CMV IgG antibodies [ 15 ]. On the contrary, our data was higher than other previous studies, such as in Leningrad (78%) [ 32 ], Yemen (77.6%) [ 2 ], Sudan (74.8%) [ 33 ], Iraq (46%) [ 34 ], Libya (42.1%, 35.5%) [ 35 , 36 ], Iran (14.28%) [ 37 ], and Iraq (4.1%) [ 13 ]. There are a variety of factors that contribute to discrepancies and variations in results, such as socio-demographic status, cultures and behaviors of studied groups, and hygiene practices [ 18 ]. The time and period for collection of specimens from women and the sensitivity and specificity of diagnostic CMV techniques and markers that were selected for diagnosis may also be attributed to the differences in the results [ 2 , 24 ]. The seroconversion of CMV-specific IgG antibodies takes several weeks after the first infection or presence of undetectable levels of IgG antibodies [ 38 ]. The seropositivity of CMV IgM antibodies in this study was in 8 out of 110 aborted women (7.3%). This result was in line with that reported in Iraq and Yemen, which were 8% and 7% [ 15 , 18 ], respectively. This data was lower than several studies, such as those in Iraq (10%, 13.3%, 40%), [ 13 , 26 , 39 ], Sudan (13.3%, 38.3%) [ 31 , 33 ], Libya (16.8%, 69.7%) [ 35 , 36 ], Iran (28.25%) [ 37 ], India (20%) [ 28 ], and Niger (9.5%) [ 30 ]. One of the highest IgM antibody rates among Yemeni aborted women was 83.3% [ 2 ], while the global rate was 93%, observed in Iraq [ 16 ]. Conversely, various studies were lower than ours, including those in Iran (1.3%, 2.3%) [ 29 , 40 ], Sudan (2.2%) [ 43 ], Yemen (3.7% and 3.8%) [ 17 , 19 ], and Iraq (6%, 6%) [ 27 , 36 ]. A study undertaken among Sudanese women who had abortions revealed that there were no cases of positive CMV IgM antibodies [ 14 ]. The timing of CMV infections for mothers and their fetuses, as well as the immunity, may contribute to variations of results [ 42 ]. The timing of serodiagnosis of CMV-specific IgM is also very important because the IgM antibodies typically appear early after CMV infection and then decline to become undetectable or disappear within a few months [ 43 ]. The cross-reactivity of anti-CMV IgM with other herpesviruses, influenza viruses, and measles virus and some autoimmune diseases leads to false positive CMV results [ 43 ]. In the current study, a significant high prevalence of anti-CMV IgG was 100% (p = 0.019) among those women who had high socioeconomic status. Two studies among Yemeni women record that the women who had low, medium, and high income had the highest anti-CMV IgG antibody rates [ 17 , 18 ]. Low socioeconomic status is one of the strongest risk factors for increasing the CMV rates [ 45 ]. Most high socioeconomic status women were coming from rural areas in our study. Due to the sequences of war in our county and increasing prices and reducing currency value, there are no differences between those who are of high, medium, or low socioeconomic status. Similarly, to other previous studies, there were also no significant associations between the age, education levels, residence, and occupations of aborted women and positive anti-CMV IgG antibodies [ 2 , 17 , 18 ]. The lack of significant associations may be attributed to the relatively small number of aborted women in these studies. Meanwhile, the significant associations are lacking between all variables related to socioeconomic status or time and number of abortions, period of marriage, number of pregnancies and number of live children, symptoms and related risk factors, and rates of positive anti-CMV IgM antibodies. This may be attributed to the low seropositivity of IgM antibodies among the aborted women in these results (3.8%, 8/110). In the present data, 81.8% and 12.1% of aborted women who were exposed to recurrent abortions were positive for anti-CMV IgG and IgM antibodies, respectively. These were in agreement with three studies conducted in Niger and Yemen [ 2 , 17 , 30 ]. Our data was incompatible with that revealed in Iraq and Sudan [ 14 , 37 ]. The presence of CMV IgG antibodies may indicate past exposure to the virus, while positive IgM antibodies may indicate a recent acute CMV infection [ 27 ]. From the analysis of this data, one hundred percent of aborted women who were married for 7–9 years were positive for anti-CMV IgG antibodies, while 13% of women whose period of marriage was less than 2 years were found to be positive for anti-CMV IgM antibodies. Furthermore, there was a significant association between seropositive IgG and a period of marriage of 7–9 years (p = 0.01). This result was considered first because this variable was not indicated in previous literature. The long-term marriages may increase the exposure of women to CMV via a variety of routes, including the sexual route, due to exposure to contaminated body fluids such as saliva, semen, and vaginal secretions [ 46 ]. Consequently, these results detected that 100% and 9.1% of aborted women who became pregnant for 2–3 times had positive IgG and IgM antibodies, respectively. The positive IgG against CMV was also significantly associated with the women who had pregnancies 2–3 times (p = 0.030). Our findings were also reported as the first findings among aborted women. In this study, the highest IgG positivity rate was 83.3%, observed among women who had 2–3 live children, while the highest anti-CMV IgM positivity rate was 10%, reported among women who had no live child. Despite the lack of significant associations, these results were also reported for the first time among women who had abortions. Nevertheless, the number of recurrent abortions and trimesters of abortion was not statistically significant with the positive IgG and IgM antibodies among aborted women. This was similar to what was shown in the previous studies [ 2 , 17 ]. Elbushra et al. found a significant positive association between CMV IgG status and first-trimester abortion (p = 0.03) [ 33 ]. Regarding the risk factors, there is a significant association between exposure to blood transfusion and positive IgG antibodies (p = 0.047). Two studies among Yemeni aborted women revealed non-significant associations [ 2 , 17 ]. One of the main routes of CMV transmission is transfusion of contaminated blood [ 47 ]. Al-Sabri et al. reported that 96.6% of healthy blood donors were seropositive for IgG antibodies against CMV infections [ 48 ]. Limitations of the present study include the relatively small sample size of aborted women; in addition, the more rapid technique such as Polymerase Chain Reaction (PCR) is not used, and along with CMV infection, toxoplasmosis, rubella, and Herpes simplex virus, collectively termed (TORSH), are not detected. Conclusions The seroprevalence of CMV IgG was higher compared to IgM, which indicates that many aborted women were previously exposed to CMV in Lahj, Yemen. The CMV antibodies were high among women with recurrent abortions. The positive IgG against CMV was significantly associated with high socioeconomic status, a period of marriage of 7–9 years, and pregnancies 2–3 times among aborted women and previous exposure to blood transfusion, while no significant association was established between positive IgM against CMV and all variables related to socioeconomic status or time and number of abortions, period of marriage, number of pregnancies and number of live children, symptoms, and related risk factors. The highest IgG positivity rate was observed among women who had 2–3 live children, while the highest anti-CMV IgM positivity rate was reported among women who had no live child without any significant association. Declarations Acknowledgments The authors of this research wish to thank the aborted women who agreed to participate for their cooperation. They would also like to express their gratitude to the students' team who collected the data and analysis of CMV antibodies for the study. Ethics declarations Competing interests The authors declare that there is no conflict of interest Ethics approval and consent form Ethical approval: The ethical approval of this study was obtained from the Ethics Committee of the College of Medicine and Health Science at University of Science and Technology; MEC No. (MEC /AD0105). It was based on the standards of the Helsinki Declaration. The written consent form was obtained from each woman before performing any procedure. Funding Not applicable Data availability and materials All data was presented in the manuscript, no further data available and it will be available at any time. 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Seroprevalence of human cytomegalovirus (HCMV) in aborted women in Baghdad province. 2014;97-102. Ariani S, Chaichi LM. Study on the IgG and IgM antibodies rate of virus HSV, CMV and Rubella in the women with recurrent pregnancy loss history. 2014;212-222. Bushara, MKM. Detection of Anti cytomegalovirus IgG and IgM among Women with History of Abortion in Khartoum State Hospitals (Doctoral dissertation, Sudan University of Science & Technology). 2015 Faure-Bardon V, Magny JF, Parodi M, Couderc S, Garcia P, Maillotte AM, Benard M, Pinquier D, Astruc D, Patural H, Pladys P. Sequelae of congenital cytomegalovirus following maternal primary infections are limited to those acquired in the first trimester of pregnancy. Clinical infectious diseases. 2019;69(9):1526-32. Prince HE, Lapé-Nixon M. Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy. Clinical and Vaccine Immunology. 2014;21(10):1377-84. Maine GT, Stricker R, Schuler M, Spesard J, Brojanac S, Iriarte B, Herwig K, Gramins T, Combs B, Wise J, Simmons H. Development and clinical evaluation of a recombinant-antigen-based cytomegalovirus immunoglobulin M automated immunoassay using the Abbott AxSYM analyzer. Journal of clinical microbiology. 2000;38(4):1476-81. Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988–2004. Clinical infectious diseases. 2010;50(11):1439-47. Maschmann J, Hamprecht K, Dietz K, Jahn G, Speer CP. Cytomegalovirus infection of extremely low—birth weight infants via breast milk. Clinical infectious diseases. 2001;33(12):1998-2003. Ziemann M, Thiele T (). Transfusion‐transmitted CMV infection–current knowledge and future perspectives. Transfusion Medicine. 2017;27(4):238-48. Al-Sabri AM, Al-Arnoot S, Al-Madhagi AK, Al-Shamahy HA. Seroprevalence of cytomegalovirus among healthy blood donors in Sana’a City, Yemen. Infectious and Non Infectious Diseases. 2017;3:016. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version 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. 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08:13:51","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":129246,"visible":true,"origin":"","legend":"","description":"","filename":"d3ba04c3a6d34a93b6414c5784a5c6851structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7743994/v1/a0e2f92560ee713537eee425.xml"},{"id":92574827,"identity":"af7a5e38-3c7c-4971-b6bd-77b6564972eb","added_by":"auto","created_at":"2025-10-01 08:13:51","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":141255,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7743994/v1/63702fda0f2207a229679f96.html"},{"id":92574824,"identity":"0b488e01-0b5c-4f39-b042-23d0f4ddac4a","added_by":"auto","created_at":"2025-10-01 08:13:51","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":10869,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePrevalence of CMV serological markers IgG and IgM among aborted women in Lahj, Yemen\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present data detected that anti-CMV IgG and IgM antibodies were high at 27 (81.8%) and 4 (12.1%) among women who had recurrent abortion,respectively (Figure 2).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7743994/v1/19f194dad542ce0bf536c434.png"},{"id":92574823,"identity":"162ca88c-e613-45bd-a562-90baceb12ce4","added_by":"auto","created_at":"2025-10-01 08:13:51","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":7757,"visible":true,"origin":"","legend":"\u003cp\u003ePrevalence of CMV serological markers IgG and IgM according to primary and recurrent abortion among women in Lahj, Yemen.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7743994/v1/fe1e319142c216f1a3c60fc9.png"},{"id":92577130,"identity":"61235ced-6c4f-4ea9-9170-f738f15b0b09","added_by":"auto","created_at":"2025-10-01 08:37:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1079422,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7743994/v1/da415e0e-c2e3-440d-9bed-e621546692eb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of serological markers IgG and IgM antibodies against cytomegalovirus among aborted women in Lahj Governorate, Yemen","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe cytomegalovirus (CMV) infection is one of the commonest viral infections that cause miscarriage (abortion) among pregnant women [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. CMV is a member of Herpesviridae [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This virus is the leading cause of stillbirth and congenital abnormalities among fetuses and newborns, respectively [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The CMV infection may occur in three forms: primary, recurrent, or reactivation of latent infection [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The infection with CMV is based on the immune status of an individual, where the healthy individuals may exhibit no symptoms (asymptomatic), but severe life-threatening complications occur among pregnant women, immunocompromised individuals, recipients of organs (organ transplant), those receiving immunosuppressive drugs, and patients with immunodeficiency, such as acquired immunodeficiency syndrome (AIDS) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe virus can be shed in most body fluids and secretions, including saliva, tears, breast milk, and genital tract secretions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The fetus can get CMV infection from an infected mother through the placenta [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and the newborn through breastfeeding and during delivery (birth canal) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Sexual contact, kissing, unscreened transfusion of contaminated blood or blood products, and organ transplants are the common routes of transmission between adults [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eGlobally, the prevalence of CMV antibodies among aborted women varies, where immunoglobulin G (IgG) antibodies ranged from 4.1% to 100% versus 0% to 93% immunoglobulin M (IgM) antibodies [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn Yemen, four studies were conducted among Yemeni women who aborted to estimate the seropositive IgG and IgM against CMV in four different governorates, where the prevalence of IgG and IgM antibodies was 77.6% and 83.3% in Aden [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], 99% and 3.8% in Abyan [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], 98.7% and 7.33% in Ibb [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and 99.3% and 3.7% in Dhamar, respectively [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eUnderstanding the magnitude of the CMV infections among aborted women is important for exploring the epidemiology and applying the appropriate preventive measures for controlling the virus and treatment strategies for infected women, thereby reducing the risk of transplacental transmission and burden of abortion and congenital disorders. There was no single report about the seroprevalence of CMV among aborted women in Lahj Governorate. Therefore, our study was conducted for the first time in this governorate, where it aimed to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies among aborted women in Lahj Governorate, Yemen, and to determine possible associated factors that contribute to CMV infection among those women.\u003c/p\u003e"},{"header":"Subjects and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy area and design\u003c/h2\u003e\u003cp\u003eThis study was analytical cross-sectional conducted in Lahj Governorate, Yemen, to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies and risk factors associated with CMV infection among aborted women from February 1, to June 15, 2025. This study is a type of observational studies in which the collection and analysis of data study group at a single point in time without follow up as well as both outcomes and exposures of study group are determined at the same time [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSample size\u003c/h3\u003e\n\u003cp\u003eThe sample size of women with a previous history of abortion was calculated after obtaining the prevalence of CMV among aborted women from a study conducted in Abyan, Yemen, where the rate was 99% (17). The sample size was calculated based on Stephen Thompson's formula: \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:N=\\frac{{\\varvec{Z}}^{2}\\varvec{P}(1-\\varvec{P})}{{\\varvec{d}}^{2}}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;expected minimum sample size, Z\u0026thinsp;=\u0026thinsp;standard, corresponding to 95% confidence (1.96), P\u0026thinsp;=\u0026thinsp;the % estimated prevalence at 99% (0.99), and D\u0026thinsp;=\u0026thinsp;maximum likely error taken as 5% [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:=\\frac{{\\varvec{Z}}^{2}\\varvec{P}(1-\\varvec{P})}{{\\varvec{d}}^{2}}=\\frac{{(1.96)}^{2}\\times\\:98.7\\varvec{\\%}(1-9.17\\varvec{\\%})}{{\\left(5\\varvec{\\%}\\right)}^{2}}=\\)\u003c/span\u003e\u003c/span\u003e20 women.\u003c/p\u003e\u003cp\u003eDuring collection of data and blood specimens, 110 women were enrolled in this study, which was more than the sample size because all of these women came at the same time and met the criteria for inclusion in the study.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003e Data were collected by interviewing the participants after obtaining a signed informed consent form and using a previously designed questionnaire that was modified to be available for our study. It included age, education level, residence, occupation, and economic status. It also includes clinical history data such as primary abortion, recurrent abortion, and number of abortions; trimester of abortion for those who had recurrent abortion; period of marriage; number of pregnancies; and the live birth number. The presence of symptoms related to infection among women is noted, and two commonly important risk factors include exposing women to blood transfusion and use of corticosteroid drugs [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The women with a history of abortion were included in our study. Those women who were not exposed to abortion, children, or single women and underage girls were excluded from this study.\u003c/p\u003e\n\u003ch3\u003eLaboratory procedures\u003c/h3\u003e\n\u003cp\u003eFive ml of blood was collected from all the women using plain vacutainer tubes that were transported to the laboratory of Tour Sina Hospital in Saber City, Lahj. The sera were separated from clotted blood using a centrifuge, and the unprocessed sera were stored at \u0026minus;\u0026thinsp;80\u0026deg;C till processing. The specific anti-CMV IgG and IgM antibodies were determined using a commercially fully automated cobas\u0026reg; e 411 analyzer (Roche Diagnostics Germany) that was based on electrochemiluminescence immunoassay (ECLIA) because its sensitivity and specificity were greater than 97%. The calibration of the analyzer is done according to the instructions of the manufacturer before testing the sera using provided standards and controls. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eThe data were entered, then analyzed using the Statistical Package for the Social Sciences (SPSS\u0026reg;) software (Version 26). The ages of aborted women were abnormally distributed, so the median values and interquartile range (IQR) were determined. Almost all the data were qualitative. Therefore, they were represented as numbers and percentages. The significant associations between different variables are determined by using the chi-square (χ\u0026sup2;) test to calculate the probability value (p-value). A p-value equal to or less than 0.05 suggests a statistically significant result.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe aborted women (n\u0026thinsp;=\u0026thinsp;110) included in our study had a median age of 26 (IQR\u0026thinsp;=\u0026thinsp;7) years. According to the sociodemographic characteristics of women, the majority of women were 36 (32.7%) in the age group 26\u0026ndash;29 years, 61 (55.5%) had a secondary school education level, 76 (69.1%) were from urban areas, 72 (65.5%) had a medium income, and 74 (67.3%) were housewives (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe sociodemographic characteristics of 110 aborted women in Lahj, Yemen.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eParentage %\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u0026ndash;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocioeconomic status\u003c/b\u003e (income)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousewife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDaily work\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivate work\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe overall prevalence of IgG and IgM antibodies to CMV infections was 89 (80.9%) and 8 (7.3%), respectively (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The highest IgG rates were 20 (87%) among women in the age group 22\u0026ndash;25 years, 52 (85.2%) among those with a secondary school education, 64 (84.2%) in those from urban areas, 13 (100%) in those with a high income, and 8 (100%) among women who work daily. The prevalence of IgM was also high: 4 (11.1%) in group 26-29-year-old women, 1 (14.3%) illiterate, 6 (7.9%) urban, 2 (15.4%) with high income, and 7 (9.5%) housewives. With the exception of high-income aborted women (p\u0026thinsp;=\u0026thinsp;0.019), all these results were not statistically significant (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe present data detected that anti-CMV IgG and IgM antibodies were high at 27 (81.8%) and 4 (12.1%) among women who had recurrent abortion,respectively (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of CMV serological markers IgG and IgM among aborted women related to their sociodemographic status in Lahj, Yemen\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eIgG positive\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eIgM positive\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003eAge groups/years\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;22 (n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.818\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.213\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u0026ndash;25 (n\u0026thinsp;=\u0026thinsp;23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e87.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26 \u0026minus;\u0026thinsp;29 (n\u0026thinsp;=\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;29 (n\u0026thinsp;=\u0026thinsp;21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIlliterate \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;7)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.288\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.845\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;22)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;61)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;20)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRuler (n\u0026thinsp;=\u0026thinsp;34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.527\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban(n\u0026thinsp;=\u0026thinsp;76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocioeconomic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;25)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.449\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;72)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;13)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousewife\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;74)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.242\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.350\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDaily \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;8)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivate\u003c/p\u003e\u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;18)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e77.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployment (n\u0026thinsp;=\u0026thinsp;10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e70.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs regards the highest rates of CMV with serological markers IgG and IgM among aborted women according to the number of recurrent abortions, they were 18 (85.7%) and 4 (19%) among women who were exposed to abortion two times and 31 (86.1%) and 5 (8.2%) among women aborted in the second and first trimesters, 19 (100%) and 3 (13%) among women whose period of marriage was 7\u0026ndash;9 years and \u0026lt;\u0026thinsp;2 years, and 11 (100%) and 1 (9.1%) among women with 2\u0026ndash;3 pregnancies and 15 (83.3%) and 8 (10%) among women who had 1\u0026ndash;2 and no live children, respectively (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The significant associations were only noticed between anti-CMV IgG antibodies and period of marriage and number of pregnancies (p\u0026thinsp;=\u0026thinsp;0.01 and 0.030), respectively.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of CMV serological markers IgG and IgM among aborted women according to number of recurrent abortions and trimesters of abortion, period of marriage, number of pregnancies, and live births in Lahj, Yemen\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eIgG positive\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e\u003cp\u003eIgM positive\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003eNumber recurrent Abortion\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTwice (n\u0026thinsp;=\u0026thinsp;21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.678\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.140\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThird (n\u0026thinsp;=\u0026thinsp;9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e77.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than 3 (n\u0026thinsp;=\u0026thinsp;3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e66.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTrimesters\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1st trimester (n\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e77.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e8.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.883\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2nd trimester (n\u0026thinsp;=\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e86.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3rd trimester (n\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e7.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePeriod of marriage\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2years (n\u0026thinsp;=\u0026thinsp;23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"3\" nameend=\"c9\" namest=\"c8\" rowspan=\"4\"\u003e\u003cp\u003e0.231\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u0026ndash;6 years (n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u0026ndash;9 years (n\u0026thinsp;=\u0026thinsp;19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;9 years (n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e70.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of pregnancies\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2 (n\u0026thinsp;=\u0026thinsp;89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c9\" namest=\"c8\" rowspan=\"3\"\u003e\u003cp\u003e0.448\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u0026ndash;3 (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3 (n\u0026thinsp;=\u0026thinsp;10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of live births\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo live birth (n\u0026thinsp;=\u0026thinsp;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.841\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c9\" namest=\"c8\" rowspan=\"3\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2 children (n\u0026thinsp;=\u0026thinsp;18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2 children (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eRegarding the symptoms and the related risk factors, the rates of IgG and IgM antibodies were 9 (81.8%) and 2 (18.2%) among women who had skin rash and 3 (75.0%) and 0.0% among women who had had lymphadenopathies, respectively. About 46 (88.5%) and 5 (9.6%) of women who received blood transfusions and 9 (75%) and 2 (16.7%) who used corticosteroids had positive IgG and IgM antibodies against CMV, respectively. Only a positive IgG result was significantly associated with exposure to blood transfusion (p\u0026thinsp;=\u0026thinsp;0.047) (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of CMV serological markers IgG and IgM among aborted women according to symptoms and associated risk factors in Lahj, Yemen.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u003cp\u003eanti-CMV IgG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003eanti-CMV IgM\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eP-value\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003eP-value\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSymptoms\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSkin rash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes(n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.649\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.182\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eLymphadenopathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes(n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.577\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.736\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo(n\u0026thinsp;=\u0026thinsp;106)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRisk factors\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eBlood transfusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes(n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e88.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.047\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.299\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e74.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUse corticosteroid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes(n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.411\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.211\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo(n\u0026thinsp;=\u0026thinsp;98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe seroprevalence of CMV infections among aborted women in the Lahj governorate of Yemen was determined for the first time in the current study, where the seroprevalence of IgG antibodies against CMV was 80.9%, indicating that most aborted women were previously exposed to CMV. A study from Bangladesh revealed that 82% of women with prior miscarriages had positive anti-CMV IgG [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur finding was lower than that reported by several previous studies, such as in Yemen (99.3%, 99%, and 98.7%). [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], Iraq (98%, 96.3%, 92.9%, 92%, 89%, 85%) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], Tanzania (93.33%) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], India (92.50%) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], Iran (90.6%) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], Niger (85.7%) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], and Sudan (97.8%) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Research from Iraq recorded the highest IgG rates, where all 100% of studied aborted women had seropositive anti-CMV IgG antibodies [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOn the contrary, our data was higher than other previous studies, such as in Leningrad (78%) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], Yemen (77.6%) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], Sudan (74.8%) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], Iraq (46%) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], Libya (42.1%, 35.5%) [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], Iran (14.28%) [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], and Iraq (4.1%) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. There are a variety of factors that contribute to discrepancies and variations in results, such as socio-demographic status, cultures and behaviors of studied groups, and hygiene practices [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The time and period for collection of specimens from women and the sensitivity and specificity of diagnostic CMV techniques and markers that were selected for diagnosis may also be attributed to the differences in the results [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The seroconversion of CMV-specific IgG antibodies takes several weeks after the first infection or presence of undetectable levels of IgG antibodies [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe seropositivity of CMV IgM antibodies in this study was in 8 out of 110 aborted women (7.3%). This result was in line with that reported in Iraq and Yemen, which were 8% and 7% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], respectively. This data was lower than several studies, such as those in Iraq (10%, 13.3%, 40%), [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e39\u003c/span\u003e], Sudan (13.3%, 38.3%) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], Libya (16.8%, 69.7%) [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], Iran (28.25%) [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], India (20%) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], and Niger (9.5%) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. One of the highest IgM antibody rates among Yemeni aborted women was 83.3% [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], while the global rate was 93%, observed in Iraq [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eConversely, various studies were lower than ours, including those in Iran (1.3%, 2.3%) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e40\u003c/span\u003e], Sudan (2.2%) [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e43\u003c/span\u003e], Yemen (3.7% and 3.8%) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], and Iraq (6%, 6%) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. A study undertaken among Sudanese women who had abortions revealed that there were no cases of positive CMV IgM antibodies [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The timing of CMV infections for mothers and their fetuses, as well as the immunity, may contribute to variations of results [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. The timing of serodiagnosis of CMV-specific IgM is also very important because the IgM antibodies typically appear early after CMV infection and then decline to become undetectable or disappear within a few months [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. The cross-reactivity of anti-CMV IgM with other herpesviruses, influenza viruses, and measles virus and some autoimmune diseases leads to false positive CMV results [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn the current study, a significant high prevalence of anti-CMV IgG was 100% (p\u0026thinsp;=\u0026thinsp;0.019) among those women who had high socioeconomic status. Two studies among Yemeni women record that the women who had low, medium, and high income had the highest anti-CMV IgG antibody rates [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Low socioeconomic status is one of the strongest risk factors for increasing the CMV rates [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Most high socioeconomic status women were coming from rural areas in our study. Due to the sequences of war in our county and increasing prices and reducing currency value, there are no differences between those who are of high, medium, or low socioeconomic status.\u003c/p\u003e\u003cp\u003eSimilarly, to other previous studies, there were also no significant associations between the age, education levels, residence, and occupations of aborted women and positive anti-CMV IgG antibodies [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The lack of significant associations may be attributed to the relatively small number of aborted women in these studies.\u003c/p\u003e\u003cp\u003eMeanwhile, the significant associations are lacking between all variables related to socioeconomic status or time and number of abortions, period of marriage, number of pregnancies and number of live children, symptoms and related risk factors, and rates of positive anti-CMV IgM antibodies. This may be attributed to the low seropositivity of IgM antibodies among the aborted women in these results (3.8%, 8/110).\u003c/p\u003e\u003cp\u003eIn the present data, 81.8% and 12.1% of aborted women who were exposed to recurrent abortions were positive for anti-CMV IgG and IgM antibodies, respectively. These were in agreement with three studies conducted in Niger and Yemen [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Our data was incompatible with that revealed in Iraq and Sudan [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The presence of CMV IgG antibodies may indicate past exposure to the virus, while positive IgM antibodies may indicate a recent acute CMV infection [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFrom the analysis of this data, one hundred percent of aborted women who were married for 7\u0026ndash;9 years were positive for anti-CMV IgG antibodies, while 13% of women whose period of marriage was less than 2 years were found to be positive for anti-CMV IgM antibodies. Furthermore, there was a significant association between seropositive IgG and a period of marriage of 7\u0026ndash;9 years (p\u0026thinsp;=\u0026thinsp;0.01). This result was considered first because this variable was not indicated in previous literature. The long-term marriages may increase the exposure of women to CMV via a variety of routes, including the sexual route, due to exposure to contaminated body fluids such as saliva, semen, and vaginal secretions [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eConsequently, these results detected that 100% and 9.1% of aborted women who became pregnant for 2\u0026ndash;3 times had positive IgG and IgM antibodies, respectively. The positive IgG against CMV was also significantly associated with the women who had pregnancies 2\u0026ndash;3 times (p\u0026thinsp;=\u0026thinsp;0.030). Our findings were also reported as the first findings among aborted women.\u003c/p\u003e\u003cp\u003eIn this study, the highest IgG positivity rate was 83.3%, observed among women who had 2\u0026ndash;3 live children, while the highest anti-CMV IgM positivity rate was 10%, reported among women who had no live child. Despite the lack of significant associations, these results were also reported for the first time among women who had abortions.\u003c/p\u003e\u003cp\u003eNevertheless, the number of recurrent abortions and trimesters of abortion was not statistically significant with the positive IgG and IgM antibodies among aborted women. This was similar to what was shown in the previous studies [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Elbushra et al. found a significant positive association between CMV IgG status and first-trimester abortion (p\u0026thinsp;=\u0026thinsp;0.03) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRegarding the risk factors, there is a significant association between exposure to blood transfusion and positive IgG antibodies (p\u0026thinsp;=\u0026thinsp;0.047). Two studies among Yemeni aborted women revealed non-significant associations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. One of the main routes of CMV transmission is transfusion of contaminated blood [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Al-Sabri et al. reported that 96.6% of healthy blood donors were seropositive for IgG antibodies against CMV infections [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e48\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eLimitations of the present study include the relatively small sample size of aborted women; in addition, the more rapid technique such as Polymerase Chain Reaction (PCR) is not used, and along with CMV infection, toxoplasmosis, rubella, and Herpes simplex virus, collectively termed (TORSH), are not detected.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe seroprevalence of CMV IgG was higher compared to IgM, which indicates that many aborted women were previously exposed to CMV in Lahj, Yemen. The CMV antibodies were high among women with recurrent abortions. The positive IgG against CMV was significantly associated with high socioeconomic status, a period of marriage of 7\u0026ndash;9 years, and pregnancies 2\u0026ndash;3 times among aborted women and previous exposure to blood transfusion, while no significant association was established between positive IgM against CMV and all variables related to socioeconomic status or time and number of abortions, period of marriage, number of pregnancies and number of live children, symptoms, and related risk factors. The highest IgG positivity rate was observed among women who had 2\u0026ndash;3 live children, while the highest anti-CMV IgM positivity rate was reported among women who had no live child without any significant association.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors of this research wish to thank the aborted women who agreed to participate for their cooperation. They would also like to express their gratitude to the students\u0026apos; team who collected the data and analysis of \u0026nbsp; CMV antibodies for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEthics approval and consent form\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval: The ethical approval of this study was obtained from the Ethics Committee of the College of Medicine and Health Science at University of Science and Technology; MEC No. (MEC /AD0105). It was based on the standards of the Helsinki Declaration. The written consent form was obtained from each woman before performing any procedure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data was presented in the manuscript, no further data available and it will be available at any time. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eANMG,\u0026nbsp;supervision and revision and final editing of manuscript,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAHOQ, EYAA, EATA and FMAFK,\u0026nbsp;writing of introduction and methodology and analysis of data\u0026nbsp;HSAS, MMSM,\u0026nbsp;SNAM,\u0026nbsp;and SAAAS,\u0026nbsp;preparing of tables and figures and discussing of results,\u0026nbsp;SMAO,\u0026nbsp;SMAS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eSHAN, and\u0026nbsp;WYOA,\u0026nbsp;collection of data and samples from all women and testing of samples\u003cstrong\u003e.\u003c/strong\u003e All authors arranged the reference according to referencing style of journal, reading and making final revision of manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHassan HM, Alsamarai AM, Mohamed ZK, Aljumaili AH. 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Sudan Journal of Medical Sciences. 2013;8(4):181-4.\u003c/li\u003e\n\u003cli\u003eOdland J\u0026Oslash;, Sergejeva IV, Ivaneev MD, Jensen IP, Stray-Pedersen B. Seropositivity of cytomegalovirus, parvovirus and rubella in pregnant women and recurrent aborters in Leningrad County, Russia. Acta obstetricia et gynecologica Scandinavica. 2001;80(11):1025-9.\u003c/li\u003e\n\u003cli\u003eElbushra S, Ahmed MS, Talha AA, Gamar TA, Ahmed EA . Seroprevalence of human cytomegalovirus among pregnant women who had undergone abortion (s) attending El-Damazin Hospital for Obstetrics and Gynecology, Sudan: A cross-sectional study. F1000Research. 2019;8:1735.\u003c/li\u003e\n\u003cli\u003eAbd-ul-Aziz S . Sero-prevalence of anti-CMV-IgM and anti-CMV-IgG in Iraqi Aborted Women Infected with Human Cytomegalovirus in Nasiriyah city. University of Thi-Qar Journal. 2015;10(4):55-60.\u003c/li\u003e\n\u003cli\u003eAli MS, Qowaider SR, Almal NY, Kahald FA. 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Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy. Clinical and Vaccine Immunology. 2014;21(10):1377-84.\u003c/li\u003e\n\u003cli\u003eMaine GT, Stricker R, Schuler M, Spesard J, Brojanac S, Iriarte B, Herwig K, Gramins T, Combs B, Wise J, Simmons H. Development and clinical evaluation of a recombinant-antigen-based cytomegalovirus immunoglobulin M automated immunoassay using the Abbott AxSYM analyzer. Journal of clinical microbiology. 2000;38(4):1476-81.\u003c/li\u003e\n\u003cli\u003eBate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988\u0026ndash;2004. Clinical infectious diseases. 2010;50(11):1439-47.\u003c/li\u003e\n\u003cli\u003eMaschmann J, Hamprecht K, Dietz K, Jahn G, Speer CP. Cytomegalovirus infection of extremely low\u0026mdash;birth weight infants via breast milk. Clinical infectious diseases. 2001;33(12):1998-2003.\u003c/li\u003e\n\u003cli\u003eZiemann M, Thiele T (). Transfusion‐transmitted CMV infection\u0026ndash;current knowledge and future perspectives. Transfusion Medicine. 2017;27(4):238-48.\u003c/li\u003e\n\u003cli\u003eAl-Sabri AM, Al-Arnoot S, Al-Madhagi AK, Al-Shamahy HA. Seroprevalence of cytomegalovirus among healthy blood donors in Sana\u0026rsquo;a City, Yemen. Infectious and Non Infectious Diseases. 2017;3:016.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"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},"keywords":"Seroprevalence, CMV, aborted women, abortion, IgG, IgM, Lahj, Yemen","lastPublishedDoi":"10.21203/rs.3.rs-7743994/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7743994/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: CMV infection is one of the commonest viral infections that is related to abortion among pregnant women. Objectives: This study aimed to determine the prevalence of anti-CMV IgG and anti-CMV IgM antibodies among aborted women in Lahj Governorate, Yemen, and to determine possible associated factors that contribute to CMV infection among those women.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: An analytical cross-sectional study was conducted on 110 aborted women; five ml of blood was collected from women, sera were separated, and anti-CMV IgG and IgM were determined using a cobas® e 411 analyzer that is based on ECLIA. The data was entered and then analyzed using SPSS.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: The overall prevalence of IgG and IgM antibodies to CMV infections was 80.9% and 7.3%, respectively. High-income aborted women had a statistically significant association with positive anti-CMV IgG antibodies (p=0.019). The present data detected that anti-CMV IgG and IgM antibodies were high at 81.8% and 12.1% among women who had recurrent abortion, respectively. The significant associations were only noticed between anti-CMV IgG antibodies and period of marriage, number of pregnancies (2-3 times), and exposure to blood transfusion (p=0.01, 0.030, and 0.047), respectively. The highest IgG positivity rate was 83.3%, observed among women who had 2–3 live children, while the highest anti-CMV IgM positivity rate was 10%, reported among women who had no live child, but these results were not statistically significant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: The seroprevalence of CMV IgG was higher compared to IgM in Lahj, Yemen. The CMV antibodies were high among women with recurrent abortions. Only positive IgG against CMV was significantly associated with high socioeconomic status, a period of marriage of 7-9 years, pregnancies 2-3 times among aborted women, and previous exposure to blood transfusion. The highest IgG positivity rate was observed among women who had 2–3 live children, while the anti-CMV IgM was high among those who had no live child without any significant association.\u003c/p\u003e","manuscriptTitle":"Prevalence of serological markers IgG and IgM antibodies against cytomegalovirus among aborted women in Lahj Governorate, Yemen","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-01 08:13:47","doi":"10.21203/rs.3.rs-7743994/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":"3394ed37-90cf-4f82-80c4-beda8858bc36","owner":[],"postedDate":"October 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T18:41:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-01 08:13:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7743994","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7743994","identity":"rs-7743994","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}