Outcome of Preterm Infants With Postnatal Cytomegalovirus Infection

• Published in: Pediatrics (Evanston) Vol. 141; no. 2; p. 1
• Main Authors: Gunkel, Julia, de Vries, Linda S, Jongmans, Marian, Koopman-Esseboom, Corine, van Haastert, Ingrid C, Eijsermans, Maria C J, van Stam, Carolien, van Zanten, Bert G A, Wolfs, Tom F W, Nijman, Joppe
• Format: Journal Article
• Language: English
• Published: United States American Academy of Pediatrics 01-02-2018
• Subjects: Babies; Care and treatment; Child; Child Development; Child, Preschool; Children; Cohort Studies; Cytomegalovirus; Cytomegalovirus infections; Cytomegalovirus Infections - complications; Developmental Disabilities - etiology; Diagnosis; Gestation; Health aspects; Hearing loss; Hearing Loss - etiology; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infants; Infants (Premature); Infections; Intelligence; Intelligence Tests; Mental development; Minority & ethnic groups; Motor task performance; Neurodevelopment; Neurological complications; Pediatrics; Premature birth; Premature infants
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2017-0635

To assess whether preterm infants with postnatal cytomegalovirus infection develop neurologic sequelae in early childhood.
Infants <32 weeks' gestation were prospectively screened for cytomegalovirus (CMV) at term-equivalent age. Neurodevelopment was compared between CMV-positive and CMV-negative infants by using the Griffiths Mental Development Scales (GMDS) at 16 months' corrected age (CA); the Bayley Scales of Infant and Toddler Development, Third Edition or the GMDS at 24 to 30 months' CA; and the Wechsler Preschool and Primary Scale of Intelligence, Third Edition and Movement Assessment Battery for Children, Second Edition at 6 years of age. At 6 years old, hearing was assessed in CMV-positive children.
Neurodevelopment was assessed in 356 infants at 16 months' CA, of whom 49 (14%) were infected and 307 (86%) were noninfected. Infected infants performed significantly better on the GMDS locomotor scale. There were no differences at 24 to 30 months' CA on the Bayley Scales of Infant and Toddler Development, Third Edition or GMDS. At 6 years of age, infected children scored lower on the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, but mean scores were within normal range, reaching significance only in verbal IQ (96 [SD 17] vs 103 [SD 15] points;
= .046). Multiple regression indicated no impact of CMV status but significant influence of maternal education and ethnicity on verbal IQ. No significant differences in motor development were found and none of the infected children developed sensorineural hearing loss.
In this cohort study, postnatal cytomegalovirus infection in preterm children did not have an adverse effect on neurodevelopment within the first 6 years of life.