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School failure and deafness after "silent" congenital cytomegalovirus infection
Insights
Congenital cytomegalovirus infection, detected via IgM antibodies in newborns, is linked to lower IQ and increased hearing loss. This early infection can negatively impact neurodevelopmental outcomes in children.
Area of Science:
- Virology
- Neuroscience
- Pediatrics
Background:
- Congenital cytomegalovirus (CMV) infection is a common cause of non-genetic sensorineural hearing loss.
- The long-term neurodevelopmental effects of clinically inapparent congenital CMV infection are not fully understood.
Purpose of the Study:
- To investigate the association between congenital cytomegalovirus infection and neurodevelopmental outcomes in children.
- To assess the impact of congenital CMV on cognitive function, hearing, and school performance.
Main Methods:
- Identified newborns with IgM antibodies against cytomegalovirus (CMV) in umbilical-cord blood.
- Conducted psychometric and pediatric evaluations on antibody-positive children and matched controls.
- Assessed intelligence quotient (IQ), hearing, and behavioral and neurologic parameters.
Main Results:
- Children with congenital CMV infection showed a significantly lower mean IQ compared to controls.
- Increased prevalence of bilateral hearing loss, including profound deafness, was observed in CMV-positive children.
- Predicted school failure rates were substantially higher in children with congenital CMV infection.
Conclusions:
- Clinically inapparent congenital cytomegalovirus infection can adversely affect central nervous system development.
- Early detection and monitoring of congenital CMV are crucial for mitigating long-term neurodevelopmental consequences.
Abstract:
We found IgM antibody directed against cytomegalovirus in the umbilical-cord blood of 53 of 8644 newborns. Forty-four of the 53 had psychometric and pediatric evaluations at 3.5 to 7.0 years of age. The group's mean IQ was 102.5+/-22.4 (+/-S.D.), whereas in matched controls it was 111.7 (PC 0.025). Bilateral hearing loss was present in five of 40 children with antibody against cytomegalovirus and in one of 44 matched controls without antibody (P less than 0.1). Three of the antibody-positive children, however, had profound deafness, an abnormality that occurs once in approximately 1000 children. The predicted school failure rate, based on IQ, behavioral, neurologic and auditory test data, was 2.7 times that of matched socioeconomic controls and eight times that of randomly selected controls. We conclude that clinically inapparent congenital cytomegalovirus infection can adversely affect central-nervous-system development.