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Published on: July 24, 2016
Early-childhood cytomegalovirus infection and children's neurocognitive development
Samantha M Lee1,2, Ruth Mitchell3, Julia A Knight1,2
1Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Insights
Postnatal cytomegalovirus (CMV) infection in early childhood was linked to lower intelligence quotient (IQ) at age 8, but this effect did not persist into adolescence. These findings highlight potential impacts of CMV on cognitive development.
Area of Science:
- Pediatric infectious diseases
- Neurodevelopmental disorders
- Public health
Background:
- Congenital cytomegalovirus (CMV) infection is known to impact children's development.
- The effects of postnatal CMV infection during early childhood on cognitive development remain largely undetermined.
Purpose of the Study:
- To investigate the association between postnatal CMV infection in early childhood and neurocognitive outcomes in children.
- To determine if CMV infection has lasting effects on cognitive development from childhood through adolescence.
Main Methods:
- A population-based longitudinal study analyzed data from children with CMV infection status determined at age 7.
- Multivariate Poisson regression and Approximate Bayes Factor (ABF) analysis were used to assess the relationship between CMV infection and cognitive assessments (language, reading, memory, general intelligence) from ages 8 to 15.
- Suboptimal cognitive scores were defined as more than 2 standard deviations below the mean.
Main Results:
- Early childhood CMV infection was associated with suboptimal total IQ at age 8 (IRR=2.50, P=0.08) and suboptimal attentional control at age 8 (IRR=1.74, P=0.18).
- Association was also found with reading comprehension at age 9 (IRR=1.93, P=0.24).
- No significant association was observed for total IQ at age 15, indicating a lack of lasting cognitive effects.
Conclusions:
- Postnatal CMV infection in early childhood shows some evidence of adverse effects on general intelligence, but these effects appear to be temporary.
- Further research confirming these findings could support preventative strategies against postnatal CMV infection.
Background:
Despite a clear association seen in congenitally infected children, the effect of postnatal cytomegalovirus (CMV) infection during early childhood on cognitive development has not yet been determined.
Methods:
CMV-infection status was obtained based on serological measurements when children were 7 years old. Using population-based longitudinal data, we employed multivariate Poisson regression with a robust variance estimator to characterize the relationship between childhood CMV infection and adverse neurocognitive outcomes in children. Suboptimal neurocognitive outcomes were compared between CMV-positive and CMV-negative children using various cognitive assessments from 8 to 15 years of age. Children were evaluated on the cognitive domains of language, reading, memory and general intelligence, with a suboptimal score being >2 standard deviations lower than the mean score. Approximate Bayes factor (ABF) analysis was used to determine the level of evidence for the observed associations.
Results:
With adjustment for potential confounders, we observed that early-childhood CMV infection was associated with suboptimal total intelligence quotient (IQ) at 8 years of age [incidence-rate ratio (IRR) = 2.50, 95% confidence interval (CI) 1.35-4.62, ABF = 0.08], but not with suboptimal total IQ at 15 years of age (IRR = 0.97, 95% CI 0.43-2.19, ABF = 1.68). Suboptimal attentional control at 8 years (IRR = 1.74, 95% CI 1.13-2.68, ABF = 0.18) and reading comprehension at 9 years (IRR = 1.93, 95% CI 1.12-3.33, ABF = 0.24) were also associated with CMV infection. ABF analysis provided strong evidence for the association between CMV infection and total IQ at 8 years, and only anecdotal evidence for attentional control at 8 years and reading comprehension at 9 years. All other cognitive measures assessed were not associated with CMV infection.
Conclusion:
In this large-scale prospective cohort, we observed some evidence for adverse neurocognitive effects of postnatal CMV infection on general intelligence during early childhood, although not with lasting effect. If confirmed, these results could support the implementation of preventative measures to combat postnatal CMV infection.
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