Early neurodevelopmental outcomes in children with asymptomatic congenital CMV infection

Abstract

Background Approximately 85–90% of congenital cytomegalovirus infections (cCMV) are asymptomatic. Few studies have investigated early and long-term neurodevelopmental outcomes in children with asymptomatic cCMV (acCMV), and the data is contradictory. In the present study, we did investigate the effect of cCMV asymptomatic infection on neurological outcomes and in cognitive, language and motor development at 6 months of age. Methods Fifty-six children with cCMV asymptomatic infection were followed for 6 months, as part of a long-term surveillance program, examining their neurological and developmental outcomes. Neurological examination and Bayley-III Scales were performed. Results Clinical evaluation revealed that early neurological outcomes were essentially normal, with minor neurological deficits (i.e., tone abnormalities) in a subgroup of patients. Bayley-III scores were substantially in the normal range, with 14% showing a score less than 85 (-1SD) in the Motor Scale. Children's neurological and neurodevelopmental outcomes at 6 months of age did not differ according to the trimester of infection. Conclusions Some infants with cCMV asymptomatic infection may present minor neurological abnormalities in early stages of life. It seems useful to monitor this population for early and late neurodevelopmental sequelae.

The Audiological Follow-Up of Children with Symptomatic Congenital Cytomegalovirus Infection: An Experience in Two Italian Centers

“…The definition of symptomatic infection remains under debate. There are no definite diagnostic criteria to precisely identify the two conditions [34,35]. Consensus recommendations defining asymptomatic cCMV infection with isolated SNHL (with no apparent abnormalities to suggest cCMV disease, but sensorineural hearing loss (≥21 decibels) have been pub-lished [36].…”

Neurodevelopmental outcomes in congenital and perinatal infections

“…Neonates with asymptomatic cCMV are also at risk for abnormal neurodevelopment [6 ▪▪ ]. Studies have reported that 14, 11, and 19% of infants with asymptomatic cCMV had developmental concerns on Bayley-III at 6, 12, and 24 months of age, respectively [51 ▪ ,55 ▪ ]. Meta-analysis showed that 14% of asymptomatic newborns following maternal primary CMV infection had neurodevelopmental disorders in childhood [52].…”

Human Cytomegalovirus Induces Significant Structural and Functional Changes in Terminally Differentiated Human Cortical Neurons

“…Human cytomegalovirus (HCMV) is a common pathogen with a worldwide infection rate ranging from 60 to 90% of the population (1-3). Though infected individuals are typically asymptomatic, a subset of congenital infections (10-15%) demonstrate a risk to fetal health and development (4)(5)(6)(7)(8)(9). In such cases, a wide range of neurological symptoms may occur, including hearing impairment, cognitive deficits, learning/language disorders, and microcephaly (2,(9)(10)(11).…”

“…Interestingly, several studies have also examined neurological effects present in individuals with asymptomatic congenital infections (2,4,12,13). Together, these studies highlight HCMV's ability to negatively impact development and activity within the central nervous system (CNS).…”

“…In such cases, a wide range of neurological symptoms may occur, including hearing impairment, cognitive deficits, learning/language disorders, and microcephaly (2, 9–11). Interestingly, several studies have also examined neurological effects present in individuals with asymptomatic congenital infections (2, 4, 12, 13). Together, these studies highlight HCMV’s ability to negatively impact development and activity within the central nervous system (CNS).…”