Planning for Another Pregnancy After a Baby With Congenital CMV: What Families Should Know

Planning for Another Pregnancy After a Baby With Congenital CMV: What Families Should Know

Author: Isabelle Boucoiran, MD

As an OB/GYN who regularly counsels families about congenital cytomegalovirus (cCMV), one of the most common questions I hear from parents is: “What are the chances this could happen again?”

The good news is that the risk of having a second child born with congenital CMV is very low. While cCMV is unfortunately common in the general population, repeat cases within the same family are exceptionally rare. Fewer than five recurrent cases have ever been reported in the medical literature worldwide. That means that although recurrence is possible, it is extraordinarily uncommon.

Still, planning another pregnancy after having a baby with cCMV can bring understandable worry. Fortunately, there are practical steps individuals and couples can take to feel informed, supported, and empowered as they move forward.

Why the Recurrence Risk Is Low

Once someone has CMV, the virus remains in the body for life but usually stays in a silent, controlled (latent_ state thanks to the immune system.

So for somebody who previously had CMV in a first pregnancy, the risk for a future pregnancy would be due to the reactivation of the latent virus, or due to reinfection with another strain of the virus.

But after a CMV infection, the body builds an immune response which reduces the risk of reactivation or reinfection.

Steps You Can Take Before and During Pregnancy

For individuals or families hoping to grow their family after a previous cCMV-affected pregnancy, there are several options to minimize and monitor risk. These are not required, but many families find them reassuring.

1. Delay pregnancy for at least 6 months after CMV infection

This will give times to your immune system to control the infection.

2. Reduce CMV Exposure

Although the recurrence risk is already low, taking steps to reduce CMV exposure for both the pregnant persons and her partner could be beneficial. This includes handwashing after contact with young children’s saliva or diapers, avoiding sharing food or utensils with them, and practicing routine hygiene around body fluids.

3. Partner With a Maternal–Fetal Medicine (MFM) Specialist: An MFM provider can:

• Review your prior pregnancy history
• Offer personalized counseling on recurrence risk
• Design a monitoring plan that fits your comfort level
• Coordinate advanced imaging or testing if needed

Of note there is no value in monitoring CMV serology, blood viral load or urine shedding during pregnancy to assess the risk of recurrence.

Many families find that meeting with an MFM specialist early—even before conception—provides clarity and peace of mind.

Moving Forward With Confidence

Welcoming a second child after a cCMV-affected pregnancy can be filled with mixed emotions—hope, excitement, and understandable concern. As an OB/GYN, I want families to know that:

The chance of recurrence is very low, with only a handful of cases ever documented. There are clear, practical steps to further decrease the risk.

You are not alone—your OB/GYN, MFM specialist, and clinical care team can partner with you every step of the way.

With individualized support and thoughtful planning, most families go on to have healthy pregnancies and healthy babies.

If you have questions about your personal risk or would like help developing a preconception or pregnancy plan, please reach out to your OB/GYN or an MFM specialist. The National CMV Foundation is also here to support you with reliable information, advocacy, and community resources.

Dr. Boucoiran is a clinician-researcher in obstetrics-gynecology specializing in maternal-fetal medicine and infectious reproductive diseases. She is a member of the School of Public Health of the University of Montreal and the Department of Obstetrics and Gynecology at CHU Sainte-Justine, where she co-directs the Centre d’infectiologie mère-enfant (CIME), a provincial reference for congenital infections.