Pollick Sarah A, Noorulla Fatima, Harrison Gail Demmler, Nikirk Samantha, Hijawi Jenna, Sturza Julie, Pesch Megan H
Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.
Division of Pediatric Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Pediatr Res. 2025 Sep 9. doi: 10.1038/s41390-025-04327-z.
Children with congenital cytomegalovirus (cCMV) have a wide spectrum of possible neurodevelopmental outcomes.
To describe neurodevelopmental (ND) Phenotypes of children with cCMV based on medical, developmental, and behavioral outcomes in childhood, and examine whether birth characteristics were associated with ND Phenotype.
Caregivers of children with cCMV (N = 242, child aged 12 months to <11 years) completed survey instruments reporting on the child's birth characteristics, reasons for cCMV testing, and present medical, developmental, and behavioral status. Latent Class Analysis was used to derive empirically driven groupings of outcomes, which we called ND Phenotypes. Chi-square analyses and t-tests examined the association between ND Phenotypes with child characteristics.
Five ND Phenotypes were identified: 1) No sequelae with or without Isolated SNHL (n = 44, 18%), 2) High Medical and Neurodevelopmental Involvement (n = 31, 13%) 3) Some Developmental Delays with Mild Neuromuscular Involvement (n = 49, 20%) 4) Isolated Speech and Language Delays (n = 89, 37%) and 5) Autism and Global Developmental Delay (n = 29, 12%). ND Phenotype membership was predicted by birth characteristics and reason for cCMV testing.
Five ND Phenotypes of children with cCMV were identified. Future studies should examine stability of class membership over time.
Five neurodevelopmental phenotypes of children with congenital cytomegalovirus were identified. All but one phenotype consisted of children with multiple long-term medical and neurodevelopmental sequelae. Physical findings, prematurity and intensive care admission at birth were associated with severity of outcome. Children tested for congenital cytomegalovirus due to a failed newborn hearing screen alone were most likely to have no long-term developmental delays.
先天性巨细胞病毒（cCMV）感染的儿童有多种可能的神经发育结局。
根据儿童期的医学、发育和行为结局，描述cCMV感染儿童的神经发育（ND）表型，并检查出生特征是否与ND表型相关。
cCMV感染儿童（N = 242，年龄12个月至<11岁）的照顾者完成了调查问卷，报告儿童的出生特征、cCMV检测原因以及当前的医学、发育和行为状况。采用潜在类别分析得出基于经验的结局分组，我们称之为ND表型。卡方分析和t检验检查了ND表型与儿童特征之间的关联。
确定了五种ND表型：1）无后遗症，伴有或不伴有孤立性感音神经性听力损失（n = 44，18%），2）高度医学和神经发育受累（n = 31，13%），3）一些发育延迟伴轻度神经肌肉受累（n = 49，20%），4）孤立性言语和语言延迟（n = 89，37%），5）自闭症和全面发育迟缓（n = 29，12%）。ND表型类别由出生特征和cCMV检测原因预测。
确定了cCMV感染儿童的五种ND表型。未来的研究应检查类别成员随时间的稳定性。
确定了先天性巨细胞病毒感染儿童的五种神经发育表型。除一种表型外，所有表型均包括有多种长期医学和神经发育后遗症的儿童。体格检查结果、早产和出生时入住重症监护病房与结局严重程度相关。仅因新生儿听力筛查未通过而接受先天性巨细胞病毒检测的儿童最有可能没有长期发育延迟。
