Neonatal characteristics and neurodevelopmental phenotypes in congenital cytomegalovirus

Children with congenital cytomegalovirus (cCMV) have a wide spectrum of possible neurodevelopmental outcomes.

To describe neurodevelopmental (ND) Phenotypes of children with cCMV based on medical, developmental, and behavioral outcomes in childhood, and examine whether birth characteristics were associated with ND Phenotype.

Caregivers of children with cCMV (N = 242, child aged 12 months to <11 years) completed survey instruments reporting on the child's birth characteristics, reasons for cCMV testing, and present medical, developmental, and behavioral status. Latent Class Analysis was used to derive empirically driven groupings of outcomes, which we called ND Phenotypes. Chi-square analyses and t-tests examined the association between ND Phenotypes with child characteristics.

Five ND Phenotypes were identified: 1) No sequelae with or without Isolated SNHL (n = 44, 18%), 2) High Medical and Neurodevelopmental Involvement (n = 31, 13%) 3) Some Developmental Delays with Mild Neuromuscular Involvement (n = 49, 20%) 4) Isolated Speech and Language Delays (n = 89, 37%) and 5) Autism and Global Developmental Delay (n = 29, 12%). ND Phenotype membership was predicted by birth characteristics and reason for cCMV testing.

Five ND Phenotypes of children with cCMV were identified. Future studies should examine stability of class membership over time.

Five neurodevelopmental phenotypes of children with congenital cytomegalovirus were identified. All but one phenotype consisted of children with multiple long-term medical and neurodevelopmental sequelae. Physical findings, prematurity and intensive care admission at birth were associated with severity of outcome. Children tested for congenital cytomegalovirus due to a failed newborn hearing screen alone were most likely to have no long-term developmental delays.