Zhang Xin-Wen, Li Fen, Yu Xue-Wen, Shi Xiao-Wei, Shi Jian, Zhang Jian-Ping
Maternal and Child Health Center, The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an 710061, People's Republic of China.
J Clin Virol. 2007 Nov;40(3):180-5. doi: 10.1016/j.jcv.2007.08.018.
Although about 90% of congenital cytomegalovirus (CMV) infection is asymptomatic in newborn, some of them could show sequelae later in life. Qinba mountain area is a place with high incidence of mental retardation and a high rate of CMV intrauterine transmission in China. The correlation between asymptomatic congenital CMV infection and developmental outcomes of children in this area remain unclear.
To investigate the impact of asymptomatic congenital CMV infection on physical and intellectual development of children during the first 6 years of life in Qinba mountain area.
Longitudinal cohort study. Forty-nine of all the 54 children with asymptomatic congenital CMV infection were followed prospectively in a study for surveying physical growth and intellectual developments.
Either in neonatal or in infant period, no significant difference was noted between the asymptomatic congenital CMV infection children and the controls in average weight, height and head circumference (both p>0.05). The intellectual development was disproportion in asymptomatic congenital infected children. Compared with the control group, both global development quotient (DQ) and full-scale intelligence quotient (IQ) scores of asymptomatically infected children were worse (t=2.19, p=0.031; t=2.48, p=0.015), especially on language DQ scores (t=3.25, p=0.002) and verbal IQ scores (t=3.88, p=0.000). However, the incidence rates of mental retardation (DQ/IQ<70) were similar in two groups (chi(2)=1.03, p>0.05).
Although asymptomatic congenital CMV infection did not have significant influence on the neonatal physical development or incidence of mental retardation later in life, it is obviously an important factor correlating with long-time cognitive outcomes, especially on the development of language. It is necessary to survey CMV congenital infection and monitor the early intellectual development of children with asymptomatic congenital CMV infection in this area.
尽管约90%的先天性巨细胞病毒(CMV)感染在新生儿期无症状,但其中一些人日后可能会出现后遗症。中国秦巴山区是智力发育迟缓发病率高且CMV宫内传播率高的地区。该地区无症状先天性CMV感染与儿童发育结局之间的相关性尚不清楚。
探讨秦巴山区无症状先天性CMV感染对儿童出生后6年内身体和智力发育的影响。
纵向队列研究。对54例无症状先天性CMV感染儿童中的49例进行前瞻性随访,以调查身体生长和智力发育情况。
在新生儿期或婴儿期,无症状先天性CMV感染儿童与对照组在平均体重、身高和头围方面均无显著差异(均p>0.05)。无症状先天性感染儿童的智力发育不均衡。与对照组相比,无症状感染儿童的总体发育商(DQ)和全量表智商(IQ)得分均较差(t=2.19,p=0.031;t=2.48,p=0.015),尤其是语言DQ得分(t=3.25,p=0.002)和言语IQ得分(t=3.88,p=0.000)。然而,两组智力发育迟缓(DQ/IQ<70)的发生率相似(χ2=1.03,p>0.05)。
尽管无症状先天性CMV感染对新生儿身体发育或日后智力发育迟缓的发生率没有显著影响,但它显然是与长期认知结局相关的重要因素,尤其是对语言发育的影响。有必要对该地区先天性CMV感染进行调查,并监测无症状先天性CMV感染儿童的早期智力发育情况。