Long-term impairment attributable to congenital cytomegalovirus infection: a retrospective cohort study
Korndewal, Marjolein J; Oudesluys-Murphy, H M Anne Marie; Kroes, Aloys C M; van der Sande, Marianne A B; de Melker, Hester E.; Vossen, Ann C T M
(2017) Developmental Medicine and Child Neurology, volume 59, issue 12, pp. 1261 - 1268
(Article)
Abstract
AIM: This study aimed to estimate long-term impairment attributable to congenital cytomegalovirus infection (cCMV). METHOD: This nationwide cohort study retrospectively assessed cCMV in children born in 2008 in the Netherlands, testing 31 484 stored neonatal dried blood spots. Extensive medical data of cCMV-positive children (n=133) and matched cCMV-negative comparison children
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(n=274) up to 6 years of age were analysed. RESULTS: Moderate to severe long-term impairment was diagnosed in 24.8% (33 out of 133) of all cCMV-positive children (53.8% in symptomatic, 17.8% in asymptomatic), compared with 12.0% (33 out of 274) of cCMV-negative children. Sensorineural hearing loss was seen only in five cCMV-positive children (3.8%). Developmental delays were diagnosed more often in cCMV-positive children than cCMV-negative children: motor (12.0% vs 1.5%), cognitive (6.0% vs 1.1%), and speech-language (16.5% vs 7.3%). Long-term impairment in multiple domains was more frequent in symptomatic (19.2%) and asymptomatic (8.4%) cCMV-positive children than cCMV-negative children (1.8%). INTERPRETATION: Children with cCMV were twice as likely to have long-term impairment up to the age of 6 years, especially developmental delays and sensorineural hearing loss, than cCMV-negative comparison children, with a risk difference of 12.8%. These insights into the risk of cCMV-associated impairment can help optimize care and stimulate preventive measures. WHAT THIS PAPER ADDS: Congenital cytomegalovirus infection (cCMV) leads to impairment in 25% of cases. Fifty per cent of children with cCMV symptoms at birth have long-term impairment. The risk difference of moderate to severe long-term impairment between children with and without cCMV is 13%, attributable to cCMV. cCMV leads to motor, cognitive, and speech-language developmental delay in children.
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Keywords: Child, Child, Preschool, Cytomegalovirus Infections, Developmental Disabilities, Female, Hearing Loss, Sensorineural, Humans, Infant, Infant, Newborn, Intellectual Disability, Journal Article, Language Disorders, Male, Netherlands, Research Support, Non-U.S. Gov't, Retrospective Studies
ISSN: 0012-1622
Publisher: Wiley-Blackwell
Note: Publisher Copyright: © 2017 Mac Keith Press
(Peer reviewed)