Autism Spectrum Disorder Diagnoses and Congenital Cytomegalovirus

Area of Science:

• Pediatric Health
• Infectious Diseases
• Neurodevelopmental Disorders

Background:

• Congenital cytomegalovirus (cCMV) is a common viral infection in newborns.
• Autism spectrum disorder (ASD) is a complex neurodevelopmental condition.
• The potential link between cCMV and ASD requires further investigation.

Purpose of the Study:

• To investigate the association between congenital cytomegalovirus (cCMV) and autism spectrum disorder (ASD) administrative diagnoses in US children.
• To analyze administrative claims data to identify children with cCMV and ASD.

Main Methods:

• A cohort study utilized Medicaid claims data from 2014 to 2020.
• Diagnosis codes identified cCMV (exposure) and ASD (outcome) in children aged 0 to 7 years.
• Cox proportional hazards regression models were employed to estimate hazard ratios, adjusting for covariates and stratifying by sex, birth outcomes, and central nervous system (CNS) anomalies.

Main Results:

• The study included nearly 3 million children, identifying 1044 with cCMV and over 74,000 with ASD.
• Children with cCMV demonstrated a 2.5-fold increased likelihood of ASD diagnosis (HR: 2.5; 95% CI: 2.0-3.2).
• The association between cCMV and ASD varied by sex and the presence of CNS anomalies.

Conclusions:

• Children with cCMV diagnoses in Medicaid claims data were significantly more likely to have ASD diagnoses.
• The findings suggest a potential link between cCMV and ASD, particularly in symptomatic cases.
• Further research using universal cCMV screening cohorts is recommended to clarify these associations.