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Congenital Cytomegalovirus Infection in Children with Autism Spectrum Disorder: Systematic Review and Meta-Analysis
Kaori Maeyama1, Kazumi Tomioka1, Hiroaki Nagase1
1Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Abstract:
Association of congenital cytomegalovirus (CMV) infection with autism spectral disorder (ASD) has been suggested since 1980s. Despite the observed association, its role as a risk factor for ASD remains to be defined. In the present review, we systematically evaluated the available evidence associating congenital CMV infection with ASD using PubMed, Web of Science, Cochrane Library, and Embase databases. Any studies on children with CMV infection and ASD were evaluated for eligibility and three observational studies were included in meta-analysis. Although a high prevalence of congenital CMV infection in ASD cases (OR 11.31, 95% CI 3.07-41.66) was indicated, too few events (0-2 events) in all included studies imposed serious limitations. There is urgent need for further studies to clarify this issue.
Insights
Congenital cytomegalovirus (CMV) infection may be linked to autism spectrum disorder (ASD). However, limited data and few events in studies prevent definitive conclusions about CMV as an ASD risk factor.
Area of Science:
- Virology
- Neurodevelopmental Disorders
- Public Health
Background:
- The potential link between congenital cytomegalovirus (CMV) infection and autism spectrum disorder (ASD) has been hypothesized since the 1980s.
- The precise role of congenital CMV as a risk factor for ASD requires further investigation.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on the association between congenital CMV infection and ASD.
- To evaluate the prevalence of congenital CMV infection in children diagnosed with ASD.
Main Methods:
- A systematic literature search was conducted across PubMed, Web of Science, Cochrane Library, and Embase.
- Eligible studies involving children with CMV infection and ASD were identified and included in a meta-analysis.
- Three observational studies met the inclusion criteria for the meta-analysis.
Main Results:
- The meta-analysis indicated a high prevalence of congenital CMV infection in ASD cases (Odds Ratio: 11.31, 95% Confidence Interval: 3.07-41.66).
- However, the analysis was limited by a very small number of events (0-2 events) across all included studies.
- These limitations significantly restrict the interpretation of the findings.
Conclusions:
- While preliminary findings suggest a potential association, the current evidence is insufficient to establish congenital CMV as a definitive risk factor for ASD.
- Further high-quality research with larger sample sizes and more events is urgently needed to clarify the relationship between congenital CMV infection and autism spectrum disorder.
