Korndewal Marjolein J, Oudesluys-Murphy Anne Marie, Kroes Aloys C M, van der Sande Marianne A B, de Melker Hester E, Vossen Ann C T M
Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands.
Dev Med Child Neurol. 2017 Dec;59(12):1261-1268. doi: 10.1111/dmcn.13556. Epub 2017 Oct 9.
This study aimed to estimate long-term impairment attributable to congenital cytomegalovirus infection (cCMV).
This nationwide cohort study retrospectively assessed cCMV in children born in 2008 in the Netherlands, testing 31 484 stored neonatal dried blood spots. Extensive medical data of cCMV-positive children (n=133) and matched cCMV-negative comparison children (n=274) up to 6 years of age were analysed.
Moderate to severe long-term impairment was diagnosed in 24.8% (33 out of 133) of all cCMV-positive children (53.8% in symptomatic, 17.8% in asymptomatic), compared with 12.0% (33 out of 274) of cCMV-negative children. Sensorineural hearing loss was seen only in five cCMV-positive children (3.8%). Developmental delays were diagnosed more often in cCMV-positive children than cCMV-negative children: motor (12.0% vs 1.5%), cognitive (6.0% vs 1.1%), and speech-language (16.5% vs 7.3%). Long-term impairment in multiple domains was more frequent in symptomatic (19.2%) and asymptomatic (8.4%) cCMV-positive children than cCMV-negative children (1.8%).
Children with cCMV were twice as likely to have long-term impairment up to the age of 6 years, especially developmental delays and sensorineural hearing loss, than cCMV-negative comparison children, with a risk difference of 12.8%. These insights into the risk of cCMV-associated impairment can help optimize care and stimulate preventive measures.
Congenital cytomegalovirus infection (cCMV) leads to impairment in 25% of cases. Fifty per cent of children with cCMV symptoms at birth have long-term impairment. The risk difference of moderate to severe long-term impairment between children with and without cCMV is 13%, attributable to cCMV. cCMV leads to motor, cognitive, and speech-language developmental delay in children.
本研究旨在评估先天性巨细胞病毒感染（cCMV）所致的长期损害。
这项全国性队列研究对2008年在荷兰出生儿童中的cCMV进行了回顾性评估，检测了31484份储存的新生儿干血斑。分析了133名cCMV阳性儿童和274名匹配的cCMV阴性对照儿童至6岁时的大量医学数据。
所有cCMV阳性儿童中，24.8%（133名中的33名）被诊断为中度至重度长期损害（有症状者为53.8%，无症状者为17.8%），而cCMV阴性儿童为12.0%（274名中的33名）。仅5名cCMV阳性儿童（3.8%）出现感音神经性听力损失。cCMV阳性儿童比cCMV阴性儿童更常被诊断为发育迟缓：运动发育迟缓（12.0%对1.5%）、认知发育迟缓（6.0%对1.1%）和语言发育迟缓（16.5%对7.3%）。有症状（19.2%）和无症状（8.4%）的cCMV阳性儿童在多个领域出现长期损害的情况比cCMV阴性儿童（1.8%）更频繁。
与cCMV阴性对照儿童相比，cCMV阳性儿童在6岁前出现长期损害的可能性是其两倍，尤其是发育迟缓和感音神经性听力损失，风险差异为12.8%。这些关于cCMV相关损害风险的见解有助于优化护理并促进预防措施。
先天性巨细胞病毒感染（cCMV）在25%的病例中会导致损害。出生时出现cCMV症状的儿童中有50%存在长期损害。有cCMV和无cCMV儿童之间中度至重度长期损害的风险差异为13%，归因于cCMV。cCMV会导致儿童出现运动、认知和语言发育迟缓。
