Features of the humoral immune response in pregnant women with chronic placental insufficiency associated with cytomegalovirus infection exacerbation

Introduction. Research into immunity in pregnant women with viral infections remains highly relevant.
Aim. To evaluate the characteristics of the humoral immune response in pregnant women with chronic placental insufficiency associated with exacerbation of cytomegalovirus (CMV) infection during the second trimester of pregnancy.
Materials and methods. A dynamic observational study was conducted in 165 pregnant women (main group) with chronic CMV infection—exacerbation in the second trimester and remission in the third trimester—including 138 patients with compensated chronic placental insufficiency (CCPI) (subgroup 1) and 27 with subcompensated chronic placental insufficiency (SCPI) (subgroup 2). The comparison group consisted of 35 CMV-seronegative pregnant women. Study materials included peripheral blood, urine, and buccal epithelium. CMV-specific immunoglobulins (Ig) M and G, CMV IgG avidity index, total IgA, IgM, and IgG, secretory sIgA, and circulating immune complexes (CIC) were measured using enzymelinked immunosorbent assay (ELISA) and turbidimetric analysis.
Results. In pregnant women with CMV exacerbation during the second trimester, a correlation was observed between the magnitude of the humoral immune response and the severity of placental insufficiency. High CMV IgG titers (1:1600 and 1:3200) were associated with more frequent viral DNA detection and significant humoral immune disturbances—namely, elevated levels of IgG (p < 0.01), IgM (p < 0.001), and CIC (p < 0.001), alongside reduced IgA (p < 0.001). An IgG titer of 1:3200 showed strong association with the development of CCPI, whereas a titer of 1:800 was linked to SCPI.
Conclusion. The findings indicate that the nature of the immune response in CMV infection—which determines disease severity and pregnancy outcomes—largely depends on the status of antiviral defense and humoral reactions, particularly the levels of CMV-specific IgG and sIgA, as confirmed by the established correlations.

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