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Published on: July 6, 2013
Hearing and neurodevelopmental outcomes among children with congenital cytomegalovirus
Jordan C Stout1, Jessica Leung2, Peter Kfoury1
1Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
Insights
Congenital cytomegalovirus (cCMV) infection is a common cause of neurodevelopmental delays and hearing loss in children. This study highlights the prevalence of these outcomes in a diverse U.S. cohort up to age six.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Developmental Pediatrics
Background:
- Congenital cytomegalovirus (cCMV) is the most frequent congenital infection and a primary non-genetic cause of sensorineural hearing loss.
- Early identification and monitoring of cCMV are crucial for managing long-term health implications.
Purpose of the Study:
- To assess the demographics, clinical characteristics, and neurodevelopmental outcomes, including hearing loss, up to six years of age in U.S. children with possible cCMV.
- To analyze data from a large, diverse cohort to understand the impact of cCMV on child development.
Main Methods:
- Retrospective cohort study utilizing the Audiological and Genetic Database (AudGenDB) from 2006-2019.
- Identification of children with possible cCMV using diagnostic codes, with analysis of clinical signs within 45 days of birth and neurodevelopmental conditions up to age six.
- Definition of hearing loss as a pure tone average or any frequency threshold ≥25 dB.
Main Results:
- 180 children with possible cCMV were identified; 70% were diagnosed after 45 days of life.
- Black and Hispanic/Latino children were disproportionately represented in the cCMV group.
- 72% of children with cCMV had diagnoses for neurodevelopmental conditions, including hearing loss (56 children), communication delays (45), and cerebral palsy (22); hearing loss was diagnosed at a median age of 2 years.
Conclusions:
- Neurodevelopmental delays are prevalent in children with cCMV.
- The AudGenDB offers valuable longitudinal data for studying cCMV outcomes in a large, diverse population.
- This data is important for informing public health strategies in the absence of universal state-mandated screenings.
Objective:
Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and the leading non-genetic cause of sensorineural hearing loss. We assessed demographics, clinical characteristics, hearing and neurodevelopmental outcomes by 6 years of age among U.S. children with possible cCMV.
Study Design:
Retrospective cohort design.
Setting:
The Audiological and Genetic Database (AudGenDB) includes 175,216 pediatric patients who underwent audiology, otology or genetic visits during 2006-2019 in Children's Hospital of Philadelphia, Vanderbilt Children's Hospital, or Boston Children's Hospital.
Methods:
Children with possible cCMV were identified by diagnostic codes for cCMV infection and CMV disease up to 6 years of age. We examined clinical signs of cCMV during 0-45 days of birth and neurodevelopmental conditions (including hearing loss) up to 6 years of age. Hearing loss was defined as pure tone average or any frequency threshold ≥25 dB.
Results:
A total of 180 (0.1 %) children with possible cCMV were identified; 70 % had diagnosis codes after 45 days of life. The proportions of Black and Hispanic/Latino children comprised a higher proportion in the possible cCMV group compared to the non-cCMV group. Overall, 129 (72 %) children with possible cCMV had diagnoses codes for neurodevelopmental conditions, including hearing loss (56), communication delays (45) and cerebral palsy (22). Hearing loss was diagnosed at a median age of 2 (1-4) years.
Conclusion:
Neurodevelopmental delays were common among children with possible cCMV included in this study. AudGenDB provides access to longitudinal outcomes for a large and diverse cohort that remains helpful in lieu of state-mandated screenings.
