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Published on: October 17, 2025
Prenatal acquired cytomegalovirus infection should be considered in children with autism
Mona-Lisa Engman1,2, Mikael Sundin1,3, Carmela Miniscalco4
1Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Insights
Congenital cytomegalovirus (CMV) infection was found in 3% of children with autism spectrum disorder and intellectual disability. This suggests CMV may be a contributing factor to this condition.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurodevelopmental Disorders
Background:
- Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with diverse etiologies.
- Congenital Cytomegalovirus (CMV) infection is a common viral infection in newborns and can have long-term neurological consequences.
Observation:
- This study investigated the prevalence of congenital CMV in preschool children diagnosed with ASD.
- Dried blood spots from newborn metabolic screening were analyzed for CMV DNA in 115 children with ASD.
Findings:
- Congenital CMV infection was detected in 3% of children with ASD and intellectual disability (ID).
- No congenital CMV was found in children with ASD but without ID.
- The prevalence of congenital CMV in this subgroup (3%) is higher than the general newborn population in Sweden (0.2%).
Implications:
- Congenital CMV infection may be one of several potential causes contributing to ASD with ID.
- The findings suggest that screening for congenital CMV should be considered in the medical evaluation of children with ASD and ID.
- Congenital CMV diagnosis necessitates regular hearing assessments due to its association with hearing loss.
Aim:
The aim of the study was to evaluate the prevalence of congenital cytomegalovirus infection (CMV) in a representative sample of children with autism spectrum disorder.
Methods:
In a representative group of 115 preschool children with autism spectrum disorder, of whom 33 also had intellectual disability, the dried blood spots from the newborn metabolic screening were analysed for CMV DNA using TaqMan polymerase chain reaction.
Results:
One of the 33 children with autism spectrum disorder and intellectual disability - 3% of that group - had congenital CMV infection. The corresponding prevalence in newborn infants in Sweden is 0.2%. None of the 82 children without intellectual disability had congenital CMV.
Conclusion:
The finding lends some further support for congenital CMV being one of the many aetiologies underlying autism spectrum disorder with intellectual disability. The rate of 3% of congenital CMV in children with autism spectrum disorder with intellectual disability has implications for the medical work-up. The finding of congenital CMV also indicates the need for repeated hearing assessments in the child. There is a need for similar studies with much larger samples.
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