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Neurodevelopmental outcome in children with congenital cytomegalovirus infection: A prospective multicenter cohort

A Keymeulen1, E De Leenheer2, A Casaer3

  • 1Department of neonatology, Ghent University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium.

Early Human Development
|May 15, 2023
PubMed

Insights

Congenital cytomegalovirus (cCMV) infection can lead to neurodevelopmental impairment in children. This study found that 70.4% of cCMV-infected children had normal outcomes, but risks for issues like ASD and speech impairment persist even in asymptomatic cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurodevelopmental Disorders

Background:

  • Congenital cytomegalovirus (cCMV) infection is the leading cause of congenital infection globally.
  • It is a significant contributor to neurodevelopmental impairments in children.
  • Current data on neurodevelopmental outcomes for cCMV-infected children, both symptomatic and asymptomatic, are limited.

Purpose of the Study:

  • To investigate and characterize the neurodevelopmental outcomes in a substantial prospective cohort of children diagnosed with cCMV.
  • To provide comprehensive data on the long-term effects of cCMV infection on child development.

Main Methods:

  • Analysis of data from 753 children within the Flemish cCMV register.
  • Assessment of neuromotor, cognitive, behavioral, audiological, and ophthalmological outcomes.
  • Prospective follow-up to evaluate developmental trajectories.

Main Results:

  • Normal neurodevelopmental outcomes were observed in 70.4% of children.
  • Mild, moderate, and severe impairments were identified in 16.9%, 7.4%, and 5.2% of cases, respectively.
  • Adverse outcomes occurred in 53.5% of symptomatic and 17.8% of asymptomatic children; autism spectrum disorder (ASD) was diagnosed in 2.5% of cases, exceeding the general population rate.

Conclusions:

  • Both symptomatic and asymptomatic cCMV infections pose risks for sequelae, with higher risks associated with first-trimester infections.
  • Key areas for follow-up include audiology, early hypotonia, potential increased risk of ASD, and speech/language impairments, even without hearing loss.
  • Multidisciplinary neurodevelopmental follow-up is crucial for all children with cCMV infection.
Abstract

Keywords:
Congenital cytomegalovirus infectionCongenital infectionNeurodevelopmental outcomeOutcome

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