Cytomegalovirus in the neonate

Cytomegalovirus infection in early life may be congenital, or acquired during delivery or in the post natal period. The incidence of congenital infection varies widely throughout the world and ranges from 0.2 to 2.2% of live births; rates in the United Kingdom are between 0.3 and 0.4%. While fewer than 10% of congenitally infected infants have clinical manifestations of CMV infection at birth, most of this group will have serious neurological handicap. Of those with no symptoms at birth about 5% will subsequently manifest CMV-related problems, the most common being sensorineural hearing loss. Most congenitally infected children are neurologically and intellectually normal. Infection is acquired early in a high proportion of infants. In one study where 50% of mothers had CMV antibodies, 12% of their infants had acquired infection by three months and 20% by one year. The mothers' gestational status and whether the infants were breast fed were major factors associated with infection. Transfusion of CMV-infected blood is another important source of CMV infection and screened blood should be given to premature infants.