Department of Pediatrics, Affiliated Shenzhen Maternal & Child Healthcare Hospital of Southern Medical University, Shenzhen, China.
Medicine (Baltimore). 2021 Sep 10;100(36):e27057. doi: 10.1097/MD.0000000000027057.
Congenital cytomegalovirus (cCMV) infection is the most common cause of childhood hearing loss (HL), although the strength of this association remains limited and inconclusive. Thus, the purpose of this study was to summarize evidence regarding the strength of the relationship between cCMV and childhood HL and to determine whether this relationship differs according to patient characteristics.
The PubMed, EmBase, and Cochrane Library databases were searched for studies evaluating the relationship between cCMV and HL from inception to September 2019. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to calculate the investigated outcomes in a random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed.
A total of 15 studies involving 235,026 children met the inclusion criteria and were included in the final analysis. The summary results indicated that cCMV infection was associated with an increased risk of HL (odds ratio [OR]: 8.45; 95% confidence interval [CI]: 3.95-18.10; P < .001), irrespective of whether studies reported sensorineural HL (OR: 5.42; 95% CI: 1.98-14.88; P = .001), or did not evaluate HL types among their patients (OR: 11.04; 95% CI: 3.91-31.16; P < .001). However, in studies conducted in the United States (P < 0.001) and published in or after 2000 (P = 0.026), the study populations included <60% males (P < 0.001). Moreover, studies of high quality (P < .001) demonstrated a significantly greater risk of HL with cCMV infection than that in the corresponding subgroups.
The study results suggest that cCMV infection increases the risk of HL. Further studies are required to investigate the association of cCMV infection with the risk of specific subtypes of HL.
先天性巨细胞病毒（cCMV）感染是儿童听力损失（HL）的最常见原因，尽管这种关联的强度仍然有限且不确定。因此，本研究的目的是总结有关 cCMV 与儿童 HL 之间关系强度的证据，并确定这种关系是否因患者特征而异。
从建库至 2019 年 9 月，检索 PubMed、EmBase 和 Cochrane Library 数据库，以评估 cCMV 与 HL 之间关系的研究。使用随机效应模型计算调查结果的比值比（OR）和相应的 95%置信区间（CI）。还进行了敏感性、亚组和发表偏倚分析。
共有 15 项研究纳入了 235026 名儿童，符合最终分析的纳入标准。汇总结果表明，cCMV 感染与 HL 的风险增加相关（OR：8.45；95%CI：3.95-18.10；P<0.001），无论研究报告的是感觉神经性 HL（OR：5.42；95%CI：1.98-14.88；P=0.001），还是未评估其患者的 HL 类型（OR：11.04；95%CI：3.91-31.16；P<0.001）。然而，在美国进行的研究中（P<0.001）和发表于 2000 年及以后的研究中（P=0.026），研究人群中男性比例<60%（P<0.001）。此外，高质量的研究（P<0.001）表明，cCMV 感染与 HL 的风险显著高于相应亚组。
研究结果表明，cCMV 感染会增加 HL 的风险。需要进一步的研究来调查 cCMV 感染与特定 HL 亚型风险之间的关联。
