Transmission can occur via multiple routes including sexual transmission, close contact, as in daycare centers, or blood and tissue exposure. CMV infections in pregnant individuals are classified as primary if the initial acquisition of virus occurs during pregnancy (seroconversion), and nonprimary if maternal antibody to CMV was present before conception (ie, seroimmunity). Nonprimary infection may be due to reactivation of latent virus or reinfection with a new strain. Clinical findings in sym