Pre‐conception care: an important yet underutilised preventive care strategy

Antonia Shand, Pamela Palasanthiran and William D Rawlinson
Med J Aust 2019; 210 (9): . || doi: 10.5694/mja2.50154
Published online: 20 May 2019

To the Editor: Bateson and Black1 do a great service in encouraging clinicians to discuss pre‐conception care with women of reproductive age.1 However, in relation to infection prevention, one area not discussed was cytomegalovirus (CMV) infection, which is the most common infectious cause and the second most common aetiology of all causes of severe congenital malformations.2 Mother to child transmission of CMV can result in prematurity, stillbirth, cerebral palsy and neurodevelopmental delay and is the most common infectious cause of hearing loss.2 Discussions about CMV prevention should ideally commence before pregnancy, as maternal CMV infection in the first trimester poses the greatest risk of harm to the fetus if mother to child transmission occurs. Such discussions should continue throughout pregnancy, as secondary maternal infection with a different strain of CMV can also result in mother to child transmission of virus,2 although the risk per infectious event is lower.

  • Antonia Shand1,2
  • Pamela Palasanthiran2,3
  • William D Rawlinson2,4

  • 1 Royal Hospital for Women, Sydney, NSW
  • 2 UNSW Sydney, Sydney, NSW
  • 3 Sydney Children's Hospital Network, Sydney, NSW
  • 4 Prince of Wales Hospital, Sydney, NSW



We thank Hayley Smithers‐Sheedy (Cerebral Palsy Alliance), Kate Daly (CMV Australia), and Lisa Hui (Mercy Hospital Melbourne) for their comments on this manuscript.

Competing interests:

No relevant disclosures


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.