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Growth Patterns in Children With Congenital Cytomegalovirus Infection
Alfredo Tagarro1,2,3, Ruth Del Valle1,3, Sara Dominguez-Rodríguez1,2,3
1From the Hospital Universitario Infanta Sofía, Grupo de Investigación en Pediatría Pediatrics, Madrid, Spain.
Insights
Congenital cytomegalovirus infection (CMVc) impacts approximately 10% of children
Area of Science:
- Pediatrics
- Infectious Diseases
- Developmental Biology
Background:
- Congenital cytomegalovirus infection (CMVc) affects 0.7%-6% of newborns.
- CMVc can manifest as low birth weight and length.
- Early growth patterns in infants with CMVc are not well-defined.
Purpose of the Study:
- To describe the growth patterns of children with CMVc during their first two years of life.
- To identify factors associated with growth impairment in children with CMVc.
Main Methods:
- An observational, multicenter study was conducted.
- Anthropometric data were collected for 383 children with CMVc up to 24 months of age.
- Data were compared against World Health Organization growth standards.
Main Results:
- At birth, 9% of infants were small for gestational age (SGA) and 17% had microcephaly.
- By 24 months, 10% had weight/length below -2 SD and 13% had head circumference below -2 SD.
- Symptomatic infants, premature infants, and those with motor/neurocognitive impairment faced higher risks of impaired growth.
Conclusions:
- Approximately 10% of children with CMVc exhibit growth deficits by 24 months.
- Growth impairment is linked to birth symptoms, prematurity, and developmental delays.
- Growth issues should be considered part of the CMVc symptomatic spectrum.
Background:
Congenital cytomegalovirus infection (CMVc) affects 0.7%-6% of recent births. Among its clinical manifestations are low weight and length at birth.
Objective:
Describe the growth patterns of children with CMVc in their early years.
Methods:
Observational, multicenter study of patients with CMVc. Anthropometric data were collected during the first 2 years of life and compared with World Health Organization standards.
Results:
Anthropometric characteristics of 383 children with CMVc were studied, of which 198 (51%) were symptomatic at birth. At birth, 9% were small for gestational age (SGA) in terms of their weight and length and 17% had microcephaly. At 24 ± 3 months, 10% had a weight and length ≤2 SD, and 13% a head circumference ≤2 SD. Of those who were SGA at birth, at 24 ± 3 months >20% remained at ≤2 SD of their weight and length. Conversely, 75% of children with low weight or length at 24 ± 3 had not been SGA at birth. 20% of infants with microcephaly at birth remained with microcephaly, and 10% of those without microcephaly developed it at 24 ± 3 months. The average growth rate in length and weight was normal. Patients who were symptomatic at birth, premature and with motor and neurocognitive impairment had a significantly higher risk of low weight and length at 24 ± 3 months.
Conclusion:
Around 10% of children with CMVc are at ≤2 SD in weight, length and head circumference at 24 ± 3 months. The lack of adequate growth is associated with symptoms at birth, prematurity and motor and neurocognitive impairment. Growth impairment could be incorporated into the symptomatic spectrum of CMVc.
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