Growth Patterns in Children With Congenital Cytomegalovirus Infection

Abstract

Background: Congenital cytomegalovirus infection (CMVc) affects 0.7%–6% of recent births. Among its clinical manifestations are low weight and length at birth. Objective: Describe the growth patterns of children with CMVc in their early years. Methods: Observational, multicenter study of patients with CMVc. Anthropometric data were collected during the first 2 years of life and compared with World Health Organization standards. Results: Anthropometric characteristics of 383 children with CMVc were studied, of which 198 (51%) were symptomatic at birth. At birth, 9% were small for gestational age (SGA) in terms of their weight and length and 17% had microcephaly. At 24 ± 3 months, 10% had a weight and length ≤2 SD, and 13% a head circumference ≤2 SD. Of those who were SGA at birth, at 24 ± 3 months >20% remained at ≤2 SD of their weight and length. Conversely, 75% of children with low weight or length at 24 ± 3 had not been SGA at birth. 20% of infants with microcephaly at birth remained with microcephaly, and 10% of those without microcephaly developed it at 24 ± 3 months. The average growth rate in length and weight was normal. Patients who were symptomatic at birth, premature and with motor and neurocognitive impairment had a significantly higher risk of low weight and length at 24 ± 3 months. Conclusion: Around 10% of children with CMVc are at ≤2 SD in weight, length and head circumference at 24 ± 3 months. The lack of adequate growth is associated with symptoms at birth, prematurity and motor and neurocognitive impairment. Growth impairment could be incorporated into the symptomatic spectrum of CMVc.

The Limitations of Cytomegalovirus DNA Detection in Cerebrospinal Fluid of Newborn Infants With Congenital CMV Infection: A Tertiary Care Neonatal Center Experience

“…5,6 Symptomatic cCMV includes at least one of the following – thrombocytopenia, petechiae, splenomegaly, hepatomegaly, hepatitis, cholestatic jaundice, intrauterine growth restriction (IUGR) and central nervous system (CNS) damage. 3,7–10…”

“…5,6 Symptomatic cCMV includes at least one of the following -thrombocytopenia, petechiae, splenomegaly, hepatomegaly, hepatitis, cholestatic jaundice, intrauterine growth restriction (IUGR) and central nervous system (CNS) damage. 3,[7][8][9][10] Neuroimaging techniques are crucial for CNS assessment and long-term prognosis, 8,9,[11][12][13][14][15][16][17] whereas examination of cerebrospinal fluid (CSF) in infants with cCMV may convey additional information on CNS involvement. 10 The elevated protein level or beta 2 microglobulin level was shown to be present in newborns with cCMV and clinical sequelae such as microcephaly, SNHL or adverse developmental outcomes.…”

Growth Velocity and Nutritional Status in Children Exposed to Zika Virus during Pregnancy from Amazonas Cohort, Brazil

“…In children with low growth rate, the infection frequently occurred in the first trimester of pregnancy (7 children, 41%). Other studies reveal an impairment of the growth pattern of children after birth in cases of congenital infection by other diseases such as HIV, syphilis and cytomegalovirus, for example, in the first trimester of pregnancy [ 62 , 63 , 64 ]. Different studies provide evidence of increased risks of adverse events (including miscarriage, fetal loss, low birth weight, and congenital malformations, especially in the central nervous system) in early ZIKV infections during pregnancy [ 13 , 58 , 59 , 65 , 66 , 67 , 68 ].…”

Cytomegalovirus (CMV) infection in HIV/AIDS patients and diagnostic values of CMV-DNA detection across different sample types

“…In our current study, the positive rate of CMV-IgG reached 99.8%. CMV is latent in most cases, but in immunocompromised individuals, the virus replicates exponentially and spreads throughout the body with the blood, causing CMV viremia and even organic CMV disease (8). CMV infection is one of the common opportunistic infections in HIV/AIDS patients.…”