The prevalence and demographic features of congenital cytomegalovirus infection in an urban area of East Asia: A population-based study

Abstract

Congenital cytomegalovirus (cCMV) infection is the leading environmental cause of childhood hearing impairment. However, its significance remains largely undocumented in many regions of the world. The purpose of this study was to investigate the prevalence and clinical features of cCMV infection in East Asia. Neonates born at a municipal hospital in Taipei were prospectively recruited and underwent concurrent hearing and CMV screenings. Those who failed the hearing screening or screened positive for CMV were subjected to a focused audiological and/or virological surveillance. The characteristics of the newborns and their mothers were compared between the CMV-positive and CMV-negative groups. Of the 1,532 newborns who underwent concurrent hearing and CMV screenings, seven (0.46%) were positive for cCMV infection. All seven CMV-positive newborns were asymptomatic at birth, and none of them developed hearing or other symptoms during a follow-up period of 14.4±6.3 months. The mothers of the CMV-positive newborns demonstrated higher gravidity (2.4 ± 1.4 vs. 2.1 ± 1.2) and parity (2.0 ± 1.2 vs. 1.6 ± 0.7) than those in the CMV-negative group; however, the difference did not reach statistical significance. The prevalence of cCMV infection in Taipei newborns was 0.46%, which is slightly lower than that of other populations and that of a previous report in the Taiwanese population. The relatively low prevalence in this study might be attributed to the improved public health system and decreased fertility rate in Taiwan.

What are the neurodevelopmental outcomes of children with asymptomatic congenital cytomegalovirus infection at birth? A systematic literature review

“…These include prospective ( n = 20), 18 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 30 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 45 retrospective ( n = 7) 22 , 23 , 29 , 31 , 35 , 43 , 44 and cross‐sectional studies ( n = 1), 19 conducted in 18 different countries; by region, 16 studies were conducted in Europe, 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 28 , 30 , 32 , 34 , 36 , 43 , 44 , 45 five in East Asia, 27 , 29 , 37 , 38 , 39 four in North America 31 , 40 , 41 ...…”

“…The age at last follow‐up ranged between 1 month and 18 years, with 6/28 studies (from three cohorts) including populations with at least 5 years of follow‐up 40 , 41 , 42 , 43 , 44 , 45 (duration unclear for one study). 19 cCMV was identified among children in the included studies via population screening ( n = 13), 18 , 21 , 27 , 29 , 33 , 34 , 38 , 39 , 41 , 42 , 43 , 44 , 45 diagnostic testing of populations with suspected infection or clinical indications ( n = 4), 19 , 20 , 22 , 26 testing of infants born to women with primary CMV infection during pregnancy ( n = 5) 23 , 24 , 32 , 35 , 37 or a combination of these ( n = 6). 25 , 28 , 30 , 31 , 36 , 40 Four studies only included infants born to women with primary maternal CMV infection, 23 , 24 , 32 , 35 whereas eight studies reported the proportion of children born to women with primary and non‐primary maternal CMV infections during pregnancy, 21 , 26 , 28 , 30 , 31 , 33 ...…”

“…The majority of studies did not report type or timing of maternal infection ( n = 16). 18 , 19 , 20 , 22 , 25 , 27 , 29 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 …”

“…The definitions of AcCMV and ScCMV varied across studies (Table 2 ), with 19 studies including hearing loss 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 36 , 37 , 38 , 39 , 43 , 44 , 45 and six studies excluding children with isolated hearing loss in their definition of ScCMV, 24 , 31 , 33 , 40 , 41 , 42 whilst three did not state how these children were categorised. 18 , 34 , 35 Additionally, 17 studies included 19 , 20 , 21 , 23 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 43 , 44 , 45 and six excluded 22 , 24 , 33 , 40 , 41 ,…”

“… 35 , 44 Seven studies reported neurodevelopmental delay outcomes without defining how they were assessed. 19 , 23 , 28 , 29 , 37 , 39 , 40 Antivirals were received by children with AcCMV in six studies 19 , 20 , 21 , 29 , 33 , 35 and by children with ScCMV in 11 studies. 19 , 20 , 21 , 23 , 25 , 26 , 27 , 29 , 30 , 33 , 38 Four studies reported use of antivirals in children with cCMV without disaggregating this information by infant's symptom status, 22 , 24 , 31 , 43 while 12 studies did not report on antiviral use.…”