Ten-Year Clinical, Developmental, and Intellectual Follow-up of Children With Congenital Cytomegalovirus Infection Without Neurologic Symptoms at One Year of Age

• Published in: Pediatrics (Evanston) Vol. 99; no. 6; pp. 800 - 803
• Main Authors: Ivarsson, Sten-A, Lernmark, Barbro, Svanberg, Lars
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL Am Acad Pediatrics 01-06-1997; American Academy of Pediatrics
• Subjects: Biological and medical sciences; Brain damage; Child; Child Development; Child, Preschool; Children & youth; Complications and side effects; Cytomegalovirus infections; Cytomegalovirus Infections - congenital; Cytomegalovirus Infections - physiopathology; Development; Diseases of mother, fetus and pregnancy; Gynecology. Andrology. Obstetrics; Humans; Infant; Infant development; Infants; Intelligence; Longitudinal Studies; Medical sciences; Neurological disorders; Neuropsychological Tests; Pediatrics; Pregnancy. Fetus. Placenta; Risk factors; Viruses; Human; Cytomegalovirus; Psychomotor development; Intellectual development; Prognosis; Herpesviridae; Betaherpesvirinae; Congenital disease; Infection; Virus; Symptomatology; School age; Viral disease; Child
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.99.6.800

This study was undertaken to ascertain whether children with congenital cytomegalovirus (CMV) infection at birth, but without neurologic symptoms at 1 year of age, differed in somatic, neurologic, developmental, or intellectual status from matched control children at long-term follow-up.
Congenital CMV infection, as demonstrated by isolation of the virus within the first week of life, was diagnosed in 44 (0.5%) of 9806 infants. From this basic CMV-infected population, children who developed neurologic disturbances including sensorineural deafness before 1 year of age were excluded (n = 7), as were those unwilling to participate (n = 2). Congenitally infected infants (n = 35) and matched control infants (n = 53) were followed up clinically and neurologically. At 21 months, development was assessed with the Griffiths' Developmental Scale and at 7 years of age neurologic status was assessed with the Stott test and intellectual development with the Wechsler Intelligence Scale for Children.
As reported previously, 18% (8/44) of the CMV-infected infants manifested symptoms at birth, as compared to 8% (4/53) in the control group. In the congenital CMV group 7% (2/30) children tested had abnormal Stott test results, as compared to 2% (1/43) in the control group. Thirty-two CMV-infected and 51 control group children were assessed with the Griffiths' scale at 21 months of age. The two groups did not differ significantly, either in mean scores (6.3 +/- 2.3 vs 6.1 +/- 1.9) or in the proportion of children with scores below normal (19% [6/32] vs 16% [8/51]). Twenty-five CMV-infected and 41 control group children were assessed with the Wechsler Intelligence Scale for Children at 7 years of age (median 86 months; range, 82 to 90 and 82 to 91, respectively). The two groups did not differ significantly, either in mean scores (5.8 +/- 2.0 vs 6.4 +/- 1.6) or in the proportion of children with scores below normal (12% [3/25] vs 5% [2/41]).
Children with congenital CMV infection are unlikely to be at an increased risk of subsequent neurodevelopmental or intellectual impairment if they show normal development at 12 months of age.