Scaramuzzino Fabiola, Di Pastena Michela, Chiurchiu Sara, Romani Lorenza, De Luca Maia, Lucignani Giulia, Amodio Donato, Seccia Annalisa, Marsella Pasquale, Grimaldi Capitello Teresa, Longo Daniela, Palma Paolo, Lancella Laura, Bernardi Stefania, Rossi Paolo, Calo Carducci Francesca Ippolita
Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Clinical Psychology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Front Pediatr. 2022 Jul 19;10:885926. doi: 10.3389/fped.2022.885926. eCollection 2022.
Congenital cytomegalovirus (cCMV) infection can follow primary and secondary maternal infection. Growing evidence indicate that secondary maternal infections contribute to a much greater proportion of symptomatic cCMV than was previously thought. We performed a monocentric retrospective study of babies with cCMV evaluated from August 2004 to February 2021; we compared data of symptomatic children born to mothers with primary or secondary infection, both at birth and during follow up. Among the 145 babies with available data about maternal infection, 53 were classified as having symptomatic cCMV and were included in the study: 40 babies were born to mothers with primary infection and 13 babies were born to mothers with secondary infection. Analyzing data at birth, we found no statistical differences in the rate of clinical findings in the two groups, except for unilateral sensorineural hearing loss (SNHL) which was significantly more frequent in patients born to mother with secondary infection than in those born to mother with primary infection (46.2 vs. 17.5%, = ). During follow up, we found a higher rate of many sequelae (tetraparesis, epilepsy, motor and speech delay, and unilateral SNHL) in the group of children born to mothers with secondary infection, with a statistical difference for tetraparesis and unilateral SNHL. Otherwise, only children born to mothers with primary infection presented bilateral SNHL both at birth and follow up. Our data suggest that the risk of symptomatic cCMV and long-term sequelae is similar in children born to mother with primary and secondary CMV infection; it is important to pay appropriate attention to seropositive mothers in order to prevent reinfection and to detect and possibly treat infected babies.
先天性巨细胞病毒（cCMV）感染可继发于母亲的原发性和继发性感染。越来越多的证据表明，母亲的继发性感染导致有症状的cCMV感染的比例比之前认为的要高得多。我们对2004年8月至2021年2月期间接受评估的患有cCMV的婴儿进行了一项单中心回顾性研究；我们比较了母亲原发性或继发性感染的有症状儿童在出生时及随访期间的数据。在145名有母亲感染相关数据的婴儿中，53名被归类为有症状的cCMV感染并纳入研究：40名婴儿的母亲为原发性感染，13名婴儿的母亲为继发性感染。分析出生时的数据，我们发现两组临床症状发生率无统计学差异，但单侧感音神经性听力损失（SNHL）在母亲继发性感染的患儿中显著高于母亲原发性感染的患儿（46.2%对17.5%，P = ）。在随访期间，我们发现母亲继发性感染的儿童组中许多后遗症（四肢瘫痪、癫痫、运动和语言发育迟缓以及单侧SNHL）的发生率更高，四肢瘫痪和单侧SNHL有统计学差异。此外，只有母亲原发性感染的儿童在出生时和随访时均出现双侧SNHL。我们的数据表明，母亲原发性和继发性CMV感染的儿童中，有症状的cCMV感染风险和长期后遗症相似；重要的是要对血清学阳性的母亲给予适当关注，以预防再次感染，并检测和可能治疗受感染的婴儿。
