Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.
J Int Med Res. 2024 Sep;52(9):3000605241274226. doi: 10.1177/03000605241274226.
Congenital cytomegalovirus infection (cCMV) is a common, frequently unrecognized cause of childhood disability. The aim of the present study was to determine the symptoms that raise the suspicion of cCMV, define the neurodevelopmental outcomes, and assess their correlations.
This longitudinal observational study comprised 78 children with symptomatic cCMV who underwent neuropediatric follow-up for 4 to 17.9 years.
Symptoms of central nervous system involvement, hearing/visual impairments, and hepatic involvement were mostly recognized. The average age of disease suspicion was 3.3 months. In terms of outcomes, 10.53% of the children developed complex minor neurological dysfunction and 23.68% developed cerebral palsy. Visual and hearing impairments occurred in 38.16% and 14.47% of patients, respectively. Intellectual disability was present in 30.26% of patients, and epilepsy in 21.05%. Microcephaly and hearing impairment was significantly associated with overall neurodevelopmental outcome. Microcephaly was also associated with poor motor outcomes, hearing impairment, and severe visual impairment. Furthermore, microcephaly and intrauterine growth restriction were significantly associated with poor cognitive outcomes.
Symptoms that raised the suspicion of cCMV-especially microcephaly, hearing impairment, and intrauterine growth restriction-were important parameters that were associated with outcomes; however, their recognition was often insufficient and/or late.
先天性巨细胞病毒感染（cCMV）是儿童残疾的常见且常被忽视的原因。本研究旨在确定引起 cCMV 怀疑的症状，确定神经发育结局，并评估其相关性。
本纵向观察性研究纳入了 78 例有症状的 cCMV 患儿，他们接受了 4 至 17.9 年的神经儿科随访。
中枢神经系统受累、听力/视力障碍和肝受累的症状最常见。疾病怀疑的平均年龄为 3.3 个月。在结局方面，10.53%的患儿出现复杂的轻度神经功能障碍，23.68%出现脑瘫。分别有 38.16%和 14.47%的患儿出现视力和听力障碍。30.26%的患儿存在智力障碍，21.05%存在癫痫。小头畸形和听力障碍与整体神经发育结局显著相关。小头畸形也与运动功能不良、听力障碍和严重视力障碍相关。此外，小头畸形和宫内生长受限与认知结局不良显著相关。
引起 cCMV 怀疑的症状（尤其是小头畸形、听力障碍和宫内生长受限）是与结局相关的重要参数；然而，其识别往往不足且/或延迟。
