Stout Jordan C, Leung Jessica, Kfoury Peter, Germiller John A, Park Albert H, Lanzieri Tatiana M
Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Int J Pediatr Otorhinolaryngol. 2025 Aug;195:112408. doi: 10.1016/j.ijporl.2025.112408. Epub 2025 May 26.
Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and the leading non-genetic cause of sensorineural hearing loss. We assessed demographics, clinical characteristics, hearing and neurodevelopmental outcomes by 6 years of age among U.S. children with possible cCMV.
Retrospective cohort design.
The Audiological and Genetic Database (AudGenDB) includes 175,216 pediatric patients who underwent audiology, otology or genetic visits during 2006-2019 in Children's Hospital of Philadelphia, Vanderbilt Children's Hospital, or Boston Children's Hospital.
Children with possible cCMV were identified by diagnostic codes for cCMV infection and CMV disease up to 6 years of age. We examined clinical signs of cCMV during 0-45 days of birth and neurodevelopmental conditions (including hearing loss) up to 6 years of age. Hearing loss was defined as pure tone average or any frequency threshold ≥25 dB.
A total of 180 (0.1 %) children with possible cCMV were identified; 70 % had diagnosis codes after 45 days of life. The proportions of Black and Hispanic/Latino children comprised a higher proportion in the possible cCMV group compared to the non-cCMV group. Overall, 129 (72 %) children with possible cCMV had diagnoses codes for neurodevelopmental conditions, including hearing loss (56), communication delays (45) and cerebral palsy (22). Hearing loss was diagnosed at a median age of 2 (1-4) years.
Neurodevelopmental delays were common among children with possible cCMV included in this study. AudGenDB provides access to longitudinal outcomes for a large and diverse cohort that remains helpful in lieu of state-mandated screenings.
先天性巨细胞病毒（cCMV）感染是最常见的先天性感染，也是感音神经性听力损失的主要非遗传病因。我们评估了美国可能患有cCMV的儿童到6岁时的人口统计学特征、临床特征、听力及神经发育结局。
回顾性队列研究设计。
听力学与遗传学数据库（AudGenDB）纳入了2006年至2019年期间在费城儿童医院、范德比尔特儿童医院或波士顿儿童医院接受听力学、耳科学或遗传学检查的175,216例儿科患者。
通过cCMV感染和CMV疾病的诊断编码确定6岁及以下可能患有cCMV的儿童。我们检查了出生后0至45天内cCMV的临床体征以及6岁及以下的神经发育状况（包括听力损失）。听力损失定义为纯音平均听阈或任何频率阈值≥25dB。
共确定了180例（0.1%）可能患有cCMV的儿童；70%在出生45天后有诊断编码。与非cCMV组相比，可能患有cCMV的儿童中黑人及西班牙裔/拉丁裔儿童所占比例更高。总体而言，129例（72%）可能患有cCMV的儿童有神经发育状况的诊断编码，包括听力损失（56例）、沟通延迟（45例）和脑瘫（22例）。听力损失的诊断中位年龄为2（1 - 4）岁。
本研究中可能患有cCMV的儿童普遍存在神经发育延迟。AudGenDB为一个庞大且多样化的队列提供了纵向结局数据，在缺乏国家规定筛查的情况下仍有帮助。
