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Cytomegalovirus in the neonate
1Paediatric Epidemiology, Institute of Child Health, London, UK.
The Journal of Antimicrobial Chemotherapy
|June 1, 1989
Summary
Cytomegalovirus (CMV) infection in infants can be congenital or acquired, potentially leading to serious neurological issues or sensorineural hearing loss, especially in symptomatic newborns. Early detection and intervention are crucial for managing CMV
Area of Science:
- Virology
- Pediatrics
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) infection is a significant concern in early life, acquired congenitally, during delivery, or postnatally.
- Congenital CMV infection rates vary globally (0.2-2.2% of live births), with lower rates in the UK (0.3-0.4%).
- While most congenitally infected infants are asymptomatic at birth, a subset develops severe neurological handicaps.
Purpose of the Study:
- To summarize the epidemiology and clinical implications of early-life Cytomegalovirus (CMV) infection.
- To highlight the risks associated with congenital and acquired CMV infections in infants.
- To inform on factors influencing postnatal CMV acquisition and prevention strategies.
Main Methods:
- Review of existing literature on congenital and early-life Cytomegalovirus (CMV) infection.
- Analysis of incidence rates and risk factors from global and regional studies.
- Examination of clinical outcomes, including neurological and audiological sequelae.
Main Results:
- Fewer than 10% of congenitally infected infants show symptoms at birth, but many experience severe neurological deficits.
- Approximately 5% of asymptomatic newborns develop CMV-related issues, most commonly sensorineural hearing loss.
- Postnatal CMV acquisition is common, with maternal antibodies and breastfeeding being significant factors; 20% of infants acquired infection by one year in one study.
- Transfusion-transmitted CMV is a notable infection source, necessitating screened blood for premature infants.
Conclusions:
- Congenital Cytomegalovirus (CMV) infection poses a significant risk for long-term neurological and developmental problems, particularly in symptomatic infants.
- Early-life acquired CMV infection is frequent, influenced by maternal factors and infant feeding practices.
- Screening of blood products for CMV is essential to prevent transfusion-associated infections in vulnerable infant populations, especially premature neonates.