Outcome and management of newborns with congenital cytomegalovirus infection |
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| Institution: | 1. Service de réanimation néonatale, CHU Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France;2. Service d’ORL, CHU Necker-Enfants malades, 75015 Paris, France;1. University of Utah School of Medicine, Division of Otolaryngology - Head and Neck Surgery, Utah, United States;2. University of Utah School of Nursing, Utah, United States;3. University of Utah School of Medicine, Department of Population Health Sciences, Division of Biostatistics, Utah, United States;1. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan;3. Department of Obstetrics and Gynecology, Hyogo Prefectural Kobe Children''s Hospital, Kobe, Japan;4. Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan;1. Department of Medical and Surgical Sciences, Neonatology Unit,St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;2. Ophthalmology Unit, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;3. Department of Medical and Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;4. Department of Specialized, Experimental, and Diagnostic Medicine, Operative Unit of Microbiology and Virology, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;1. Bnai Zion Medical Center, Haifa, Israel;2. Harvard Medical School, Boston, USA |
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| Abstract: | Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of hearing loss and neurological disorder in children. Its overall prevalence is approximately 0.5% in Europe. In France, systematic screening during pregnancy is not recommended; screening is performed only if there are maternal or fetal symptoms suggestive of this infection. Approximately 90% of infected newborns are asymptomatic at birth, and among them the risk of neurosensory sequelae is 5–15%. By contrast, the prevalence of neurosensory impairment in symptomatic newborns at birth varies from 17% to 60%. Congenital CMV infection must be confirmed at birth before the 21st day of life by polymerase chain reaction (PCR) on saliva or urine samples. A complete clinical examination, blood tests (blood count, liver function test, CMV PCR), hearing tests, brain ultrasound and eye fundus examination should be performed. Neurological and auditory follow-up must be extended well beyond the neonatal period because the occurrence of neurosensory sequelae may be delayed. Oral valganciclovir is the recommended treatment in moderate or severe congenital CMV infections for a period of 6 weeks to 6 months; such treatment requires regular monitoring because of its possible side effects. |
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| Keywords: | Congenital cytomegalovirus infection Predictors of sequelae Hearing loss Neurological sequelae Extended follow-up |
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