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Outcome in children with symptomatic congenital cytomegalovirus infection
J F Bale1, J A Blackman, Y Sato
1Department of Pediatrics, University of Iowa College of Medicine, Iowa City.
Insights
Congenital cytomegalovirus infection can lead to severe developmental issues. Postnatal microcephaly, seizures, and abnormal brain imaging are linked to adverse outcomes in infants with symptomatic congenital cytomegalovirus.
Area of Science:
- Pediatrics
- Infectious Diseases
- Developmental Neurology
Background:
- Congenital cytomegalovirus (CMV) infection is a leading infectious cause of birth defects.
- Symptomatic congenital CMV can result in long-term neurodevelopmental sequelae.
- Identifying predictive factors for developmental outcomes is crucial for early intervention.
Purpose of the Study:
- To identify clinical, laboratory, and radiographic factors associated with adverse developmental outcomes in infants with symptomatic congenital CMV infection.
Main Methods:
- Retrospective review of 18 children with symptomatic congenital CMV infection.
- Comparison of children with adverse outcomes (developmental quotient ≤50) versus mild sequelae (developmental quotient ≥70).
- Analysis of neonatal clinical features, laboratory findings, and radiographic data, including central nervous system imaging.
Main Results:
- No significant association found between developmental outcome and neonatal clinical features (birth weight, jaundice, hepatomegaly, splenomegaly, petechiae).
- Intracranial calcifications showed a possible association with developmental outcome.
- Postnatal microcephaly, postnatal seizures, and abnormal central nervous system imaging were significantly associated with severe developmental sequelae.
Conclusions:
- Neonatal clinical presentation alone is not a reliable predictor of developmental outcome in symptomatic congenital CMV.
- Postnatal neurological signs and neuroimaging findings are critical indicators of severe neurodevelopmental impairment in congenital CMV.
- Early identification of these factors can guide prognosis and therapeutic strategies.
Abstract:
To determine factors that are associated with adverse developmental outcome after congenital cytomegalovirus infection, we reviewed the clinical, laboratory, and radiographic findings in 18 children with symptomatic congenital cytomegalovirus infections. When children with adverse outcomes (intelligence or developmental quotients of 50 or less, n = 10) were compared with children with mild sequelae (intelligence or developmental quotients of 70 or higher, n = 8), we found no relationship between developmental outcome and neonatal clinical features (birth weight, jaundice, hepatomegaly, splenomegaly, or petechiae). With the possible exception of intracranial calcifications, no single clinical or radiographic feature was associated with a specific developmental outcome. However, children who had postnatal microcephaly, postnatal seizures, and an abnormal central nervous system imaging study were more likely to have severe developmental sequelae.