A Sero-Epidemiological Inquiry on the Relationship Between Human Cytomegalovirus (HCMV) Antibodies and Spontaneous Miscarriage among Iraqi Women: A Hospital-Based Case-Control Study

Abstract

Background: Spontaneous abortion is common, multifactorial, and infectious agents, such as human cytomegalovirus (HCMV), may act as a factor associated with its occurrence, especially during the early stages of pregnancy.Objectives: This study aimed to evaluate the relationship between HCMV seropositivity and spontaneous miscarriage and to explore connections with demographic and obstetric factors in Diyala, Iraq.Materials and Methods: A hospital-based case-control study enrolled 100 women experiencing current spontaneous miscarriage alongside 100 healthy pregnant controls in February and September 2024. Immunoglobulin (Ig) titers against HCMV were assessed using ELISA. Associations were analysed using Chi-square tests and logistic regression at the 0.05 significance level.Results: The positivity of HCMV IgM was significantly elevated among miscarriage cases than among controls (22% vs. 1%; p≤ 0.001), as was the presence of HCMV IgG (93% vs. 20%; p≤ 0.001). Miscarriage occurred predominantly observed in the first trimester, accounting for 86%. This early stage was significantly linked to the likelihood of miscarriage, with an odds ratio of 14.33 (95% confidence interval = 6.27–32.79; p ≤ 0.001).Conclusion: The presence of HCMV antibodies was notably linked to spontaneous miscarriage, particularly during the first trimester.