Clinical features of cerebral palsy in children with symptomatic congenital cytomegalovirus infection

Đaković, Ivana; Andrada, Maria da Graça; Folha, Teresa; Neubauer, David; Hollódy, Katalin; Honold, M.; Horber, Veronka; Đuranović, Vlasta; Bošnjak, Vlatka Mejaški

doi:10.1016/j.ejpn.2014.04.007

Cited by 20 publications

(35 citation statements)

References 25 publications

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“…The antecedents associated with severe motor impairment were antepartum [congenital infection, small head circumference and brain maldevelopment ], intrapartum (emergency cesarean and antibiotic therapy during delivery) and postpartum (antibiotic therapy). Early congenital infections have been shown to affect organogenesis whereas later infections have been shown to be associated with brain injury . Maldevelopment was diagnosed in only a few neonates in the time period immediately after birth but a small head circumference may indicate such an underlying cause in some cases.…”

Section: Discussionmentioning

confidence: 99%

Antecedents of cerebral palsy according to severity of motor impairment

Ahlin

Himmelmann

Nilsson

et al. 2016

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 99%

Antecedents of cerebral palsy according to severity of motor impairment

Ahlin

Himmelmann

Nilsson

et al. 2016

Acta Obstet Gynecol Scand

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“…У новорожденных с ВЦМВИ выявляют ряд клинико-лабораторных и инструментальных изменений такие, как синдром задержки роста плода (СЗРП), но данные литературы разноречивы: СЗРП выявляют от 1,9% до 50% случаев [7,20,22,23,24,[27][28][29], недоношенность встречается в 26-34% случаев [7,20,29,30], а малый вес к сроку гестации -у 50-58% новорожденных с ВЦМВИ [27,30].…”

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“…слабый сосательный рефлекс 19% [30]. Микроцефалия наблюдается в 10-18,5% случаев [20,23,29,32,33], в исследовании [24] -в 28,2% случаев, по данным других авторов, в 42-56,5% случаев [7,27,28,29,30,34]. Гидроцефалию диагностируют в 15,5-23% случаев [20,24], в исследовании [20] гипертензионно-гидроцефальный синдром выявлен у 54,2% детей с ВЦМВИ с церебральной формой и у 57% -с генерализованной формой, в исследовании [32] отмечался гидроцефальный синдром у 78,6% исследуемых, а повышение внутричерепного давления у 53,9%.…”

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“…Гидроцефалию диагностируют в 15,5-23% случаев [20,24], в исследовании [20] гипертензионно-гидроцефальный синдром выявлен у 54,2% детей с ВЦМВИ с церебральной формой и у 57% -с генерализованной формой, в исследовании [32] отмечался гидроцефальный синдром у 78,6% исследуемых, а повышение внутричерепного давления у 53,9%. Судорожный синдром наблюдался у 7-13% детей [27,28,30], в исследовании [20] у 21% детей с ВЦМВИ с церебральной формой и у 26% -с генерализованной формой. Менинго-и энцефалит диагностируется в 7,85-25% случаев с ВЦМВИ с церебральной формой [14,20,32] и в 3-32% у детей с генерализованной формой [14,20].…”

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“…При проведении люмбальной пункции в ликворе обнаруживают лимфоцитарный цитоз, по данным [14], 16-20 кл в 1 мкл и белок от 0,38-0,52 г/л [36] и до >120 мг/дл, что соответствует 1,2 г/л у 46% исследуемых [30]. Также выявляют гипертонус 17,4% [28] и тремор 32,5% [32] и отек-набухание головного мозга 37,8% [20]. Изменения на НСГ выявляют в 37,7-87% случаев [23,35] [27] до 59%, по наблюдениям [20] петрификаты встречаются у 79% новорожденных с церебральной формой ВЦМВИ.…”

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The modern view of congenital Сytomegalovirus infection

et al. 2019

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Congenital cytomegalovirus infection (CMVI) ranks first among congenital infections, making contribution significantly to the variety of congenital defects formation. The review describes in details the pathogenic mechanisms of the virus effects on the fetus and newborn. Congenital CMVI develops as a result of infection of the mother with the virus or its reactivation, causing an active infection. CMV is pantropic. Infected cells acquire the characteristic appearance of an «owl’s eye» due to a 3—4-fold increase in size, and the cytoplasm is visualized only in the form of a thin strip due to the large diameter of the nucleus. With a congenital CMV infection, the virus itself, its DNA or antigens is detected in biological media up to 14—21 days of life. The manifest and asymptomatic form of infection is distinguished.Attention is drawn to the various clinical findings and long-term outcomes of the infection. When the fetus is infected in the early stages of pregnancy, various malformations of the central nervous system, cardiovascular, kidneys, etc. are formed. When infected in the late stages of pregnancy, a variety of diseases and pathological conditions are revealed in newborns. In 40—90% of newborns with manifest CMVI, there are long-term neurological consequences and hearing loss, as well as damage to the organ of vision.

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The cost‐effectiveness of maternal and neonatal screening for congenital cytomegalovirus infection in Japan

Aoki

Bitnun

Kitano

2022

Journal of Medical Virology

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Congenital cytomegalovirus infection is the most common congenital infection. Using a decision tree model, cost‐effectiveness of maternal screening with subsequent prenatal valacyclovir treatment and newborn screening with neonatal valganciclovir treatment was evaluated. The incremental cost‐effectiveness ratio (ICER) was calculated for (1) universal maternal antibody screening with prenatal valacyclovir treatment compared to targeted newborn screening, and (2) universal newborn screening with postnatal valganciclovir treatment compared to targeted newborn screening. We performed a one‐way sensitivity analysis. Compared to targeted newborn screening, the ICERs for universal newborn screening and maternal screening were 2 966 296 Japanese Yen (JPY) (21 188 USD) and 1 026 984 JPY (7336 USD), respectively. In all scenarios in the one‐way sensitivity analysis, the ICERs of the maternal screening and the universal newborn screening strategies were less than three gross domestic product per capita compared with the targeted newborn screening strategy. Both maternal and universal newborn screening strategies may be cost‐effective than a targeted newborn screening program. The potential utility of the maternal screening with valacyclovir treatment strategy, while potentially cost effective in regions with lower baseline seroprevalence rates, requires further study as the modeling was based on limited evidence.

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Clinical features of cerebral palsy in children with symptomatic congenital cytomegalovirus infection

Cited by 20 publications

References 25 publications

Antecedents of cerebral palsy according to severity of motor impairment

Antecedents of cerebral palsy according to severity of motor impairment

The modern view of congenital Сytomegalovirus infection

The cost‐effectiveness of maternal and neonatal screening for congenital cytomegalovirus infection in Japan

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