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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Outcome of Preterm Infants With Postnatal Cytomegalovirus Infection
Julia Gunkel1, Linda S de Vries1, Marian Jongmans1,2
1Departments of Neonatology.
Insights
Postnatal cytomegalovirus (CMV) infection in preterm infants did not lead to long-term neurodevelopmental problems. This study found no adverse effects on cognitive or motor skills up to age six.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Infectious Diseases
Background:
- Postnatal cytomegalovirus (CMV) infection is a concern in preterm infants.
- Potential neurologic sequelae require thorough investigation.
Purpose of the Study:
- To determine if preterm infants with postnatal CMV infection experience adverse neurodevelopmental outcomes in early childhood.
Main Methods:
- A prospective cohort study screened infants born before 32 weeks' gestation for CMV.
- Neurodevelopment was assessed using standardized tests at 16 months, 24-30 months, and 6 years corrected age.
- Hearing was evaluated in infected children at age 6.
Main Results:
- No significant differences in overall neurodevelopment or motor skills were observed between CMV-infected and non-infected infants.
- While verbal IQ was slightly lower in infected children at 6 years, scores remained within the normal range.
- Maternal education and ethnicity, not CMV status, significantly influenced verbal IQ.
Conclusions:
- Postnatal CMV infection in preterm infants does not appear to cause lasting adverse neurodevelopmental effects within the first six years of life.
- Further research may explore long-term outcomes and specific risk factors.
Objectives:
To assess whether preterm infants with postnatal cytomegalovirus infection develop neurologic sequelae in early childhood.
Methods:
Infants <32 weeks' gestation were prospectively screened for cytomegalovirus (CMV) at term-equivalent age. Neurodevelopment was compared between CMV-positive and CMV-negative infants by using the Griffiths Mental Development Scales (GMDS) at 16 months' corrected age (CA); the Bayley Scales of Infant and Toddler Development, Third Edition or the GMDS at 24 to 30 months' CA; and the Wechsler Preschool and Primary Scale of Intelligence, Third Edition and Movement Assessment Battery for Children, Second Edition at 6 years of age. At 6 years old, hearing was assessed in CMV-positive children.
Results:
Neurodevelopment was assessed in 356 infants at 16 months' CA, of whom 49 (14%) were infected and 307 (86%) were noninfected. Infected infants performed significantly better on the GMDS locomotor scale. There were no differences at 24 to 30 months' CA on the Bayley Scales of Infant and Toddler Development, Third Edition or GMDS. At 6 years of age, infected children scored lower on the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, but mean scores were within normal range, reaching significance only in verbal IQ (96 [SD 17] vs 103 [SD 15] points; P = .046). Multiple regression indicated no impact of CMV status but significant influence of maternal education and ethnicity on verbal IQ. No significant differences in motor development were found and none of the infected children developed sensorineural hearing loss.
Conclusions:
In this cohort study, postnatal cytomegalovirus infection in preterm children did not have an adverse effect on neurodevelopment within the first 6 years of life.
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