Hearing Loss in Children With Congenital Cytomegalovirus Infection in Relation to the Maternal Trimester in Which the Maternal Primary Infection Occurred

Foulon, Ina; Naessens, Anne; Foulon, Walter; Casteels, Anne; Gordts, Frans

doi:10.1542/peds.2008-0770

Cited by 72 publications

(66 citation statements)

References 19 publications

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“…Not only is the rate of abnormal outcome higher but the sequelae are more severe. 12,14,15 In fetuses confirmed to be infected, the risk of adverse perinatal outcome ranges from 20% to 45% for first trimester infections to 6% to 17% for second trimester infections. 12,[16][17][18] However, much of the existing literature is affected by methodological limitations and bias, and the wide range of adverse outcome is not helpful in prenatal counseling.…”

Section: Prediction Of Perinatal Outcome By Timing Of Maternal Infectmentioning

confidence: 99%

Perinatal outcome after maternal primary cytomegalovirus infection in the first trimester: a practical update and counseling aid

Hui

Wood

2014

Prenat Diagn

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Cytomegalovirus (CMV) is the most common cause of congenital infection with approximately 0.5% of pregnant women in developed countries seroconverting during pregnancy. In utero transmission occurs in about one third of women who develop primary infection in the first trimester, and these fetuses are at risk for adverse perinatal outcomes and long-term neurological complications. The great promise of a prenatal therapy to reduce fetal infection after maternal primary CMV infection has not been realized to date. The prediction of CMV sequelae is particularly challenging for clinicians because of the heterogeneity of the published literature, the wide spectrum of perinatal outcomes, the adjustment of fetal risk at each stage of assessment, and the variable quality of published data. Given the continued lack of a proven fetal therapy, it is timely to review the natural history of congenital CMV in the modern management era. We have analyzed the recent literature, integrated findings from multiple studies, and calculated stage-specific risks for adverse perinatal outcome to assist in counseling women with first trimester primary CMV infection.

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Section: Prediction Of Perinatal Outcome By Timing Of Maternal Infectmentioning

confidence: 99%

Perinatal outcome after maternal primary cytomegalovirus infection in the first trimester: a practical update and counseling aid

Hui

Wood

2014

Prenat Diagn

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“…A small study reported by Foulon et al [7] in 2008 related sensorineural hearing impairment in cCMV-infected children to the trimester of maternal primary CMV infection. They found 4 (80 % ) of fi ve cCMV-infected children with hearing impairment in the group of mothers with primary CMV infection in the fi rst trimester.…”

Section: Multinomial Groupmentioning

confidence: 97%

Use of cytomegalovirus hyperimmunoglobulin for prevention of congenital cytomegalovirus disease: a retrospective analysis

Buxmann

Stackelberg²,

Schlößer³

et al. 2012

Journal of Perinatal Medicine

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Aims: The aim of this study was to investigate the current prenatal " off-label use " of cytomegalovirus hyperimmunoglobulin (CMV-HIG) in the prevention and treatment of congenital CMV (cCMV) infection, including the long-term outcome of the children. Methods: This retrospective observational study comprised mothers and their children, born between January 1, 2006, and October 30, 2010. Prenatal CMV-HIG was administered after diagnosis of primary CMV infection of the mother. Clinical and virological data were collected from maternal and pediatric medical and laboratory reports. Follow-up was 12 -36 months after birth. Results: Forty-two women and 43 children met the study criteria. In total, 40 mothers and six unborn infants received 115 doses of CMV-HIG. The treatment group (TG; CMV-DNA polymerase chain reaction-positive amniotic fl uid) included four mothers; the multinomial group (MG; CMV-positive mother and unknown CMV status of fetus) included 38 mothers (39 infants). For the four unborn infants in TG, CMV-HIG was administered either intraumbilically or into the amniotic fl uid; three of the four mothers received intravenous CMV-HIG. Three children in TG remained CMV-positive and were asymptomatic at birth and during follow-up. One infant in TG had symptomatic cCMV infection in utero , at birth, and during follow-up. In MG, 37 of 38 women received intravenous CMV-HIG and two of 39 infants received CMV-HIG in utero . In total, 9 (23.1 % ) of 39 children in MG were positive for cCMV (including a terminated pregnancy). All eight instances of cCMV infection at birth in MG were asymptomatic at birth and during follow-up. The fetus from the terminated pregnancy showed no sonographic symptoms of cCMV infection. No severe side effect occurred in 115 CMV-HIG applications. Conclusion: CMV-HIG was well tolerated. Compared with published untreated mother-child pairs, we observed a trend toward a smaller risk for intrauterine CMV transmission following CMV-HIG application. Signs of prenatal cCMV disease were not reversed after CMV-HIG.

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“…The most frequent congenital infection is CMV, as vaccines have reduced the incidence of rubella, mumps, and measles. Congenital CMV infection prevalence is estimated in about 0.64% children at birth [19] . It can be a primary or a recurrent infection; only 10% of infected children are symptomatic at birth, and hearing loss may be present in about half of the cases.…”

Section: Peri-and Post-natal Hearing Lossmentioning

confidence: 99%

“…It can be a primary or a recurrent infection; only 10% of infected children are symptomatic at birth, and hearing loss may be present in about half of the cases. CMV-related sensorineural hearing defect may be of mild-moderate degree, mono-or bilateral, typically fluctuating and, for most of the cases, with a delayed onset [18][19][20][21][22] . Also, many cases of idiopathic hearing loss in children with a late diagnosis are consequences of an unknown congenital CMV infection.…”

Section: Peri-and Post-natal Hearing Lossmentioning

confidence: 99%

Moderate-Severe Hearing Loss in Children: A Diagnostic and Rehabilitative Challenge

et al. 2017

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Hearing Loss in Children With Congenital Cytomegalovirus Infection in Relation to the Maternal Trimester in Which the Maternal Primary Infection Occurred

Abstract: Hearing loss seemed more common in infants with congenital cytomegalovirus infection who were born to women who experienced a primary cytomegalovirus infection in the first trimester of pregnancy than when infection took place later in pregnancy.

Cited by 72 publications

References 19 publications

Perinatal outcome after maternal primary cytomegalovirus infection in the first trimester: a practical update and counseling aid

Perinatal outcome after maternal primary cytomegalovirus infection in the first trimester: a practical update and counseling aid

Use of cytomegalovirus hyperimmunoglobulin for prevention of congenital cytomegalovirus disease: a retrospective analysis

Moderate-Severe Hearing Loss in Children: A Diagnostic and Rehabilitative Challenge

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