Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
Neonatology. 2023;120(6):727-735. doi: 10.1159/000532084. Epub 2023 Aug 25.
There are some data indicating a negative impact of postnatal cytomegalovirus (CMV) infection on long-term neurodevelopmental outcome of preterm infants. So far, there is only little knowledge about a cerebral imaging correlate of these neurodevelopmental alterations induced by postnatal CMV infection in preterm infants. The aim of the current study was to investigate the effect of postnatal CMV infection on the incidence of brain injury and on microstructural brain maturation in very preterm infants at term-equivalent age.
Infants <32 gestational weeks (02/2011-11/2018) received cerebral MRI including axial diffusion-weighted images at term-equivalent age. All infants were screened for CMV infection using urine/saliva samples, and infection was regarded as acquired postnatal if a sample became positive >5 postnatal days. We compared brain injury as well as fractional anisotropy and apparent diffusion coefficient in 14 defined cerebral regions between infants with and without postnatal CMV infection.
401 infants were eligible, of whom 18 (4.5%) infants had a postnatal CMV infection. There were no significant differences in rates of brain injury or in microstructural brain development between both groups. This applied equally to the subgroup of infants <28 gestational weeks.
Although infants with postnatal CMV infection were born more immature and more frequently suffered from complications related to immaturity, we neither observed a higher rate of preterm brain injury nor disadvantageous alterations in microstructural brain maturation at term-equivalent age.
有一些数据表明，围生期巨细胞病毒（CMV）感染对早产儿的长期神经发育结局有负面影响。到目前为止，关于早产儿围生期 CMV 感染引起的这些神经发育改变与脑影像学的相关性，我们知之甚少。本研究的目的是探讨围生期 CMV 感染对极早产儿在矫正胎龄足月时脑损伤的发生率和脑结构微观成熟的影响。
<32 孕周的婴儿（2011 年 2 月-2018 年 11 月）在矫正胎龄足月时接受包括轴向弥散加权成像的脑 MRI。所有婴儿均采用尿液/唾液样本进行 CMV 感染筛查，如果样本在出生后 >5 天呈阳性，则认为是后天获得的感染。我们比较了有和没有围生期 CMV 感染的婴儿之间的脑损伤以及 14 个定义明确的脑区的各向异性分数和表观弥散系数。
401 名婴儿符合条件，其中 18 名（4.5%）婴儿发生了围生期 CMV 感染。两组之间脑损伤的发生率或微观脑发育均无显著差异。这同样适用于 <28 孕周的婴儿亚组。
尽管感染 CMV 的婴儿出生时更不成熟，且更常发生与不成熟相关的并发症，但我们既没有观察到更高的早产儿脑损伤发生率，也没有观察到矫正胎龄足月时微观脑成熟的不利改变。
