Ivarsson S A, Lernmark B, Svanberg L
Department of Pediatrics, University of Lund, University Hospital, Malmö, Sweden.
Pediatrics. 1997 Jun;99(6):800-3. doi: 10.1542/peds.99.6.800.
This study was undertaken to ascertain whether children with congenital cytomegalovirus (CMV) infection at birth, but without neurologic symptoms at 1 year of age, differed in somatic, neurologic, developmental, or intellectual status from matched control children at long-term follow-up.
Congenital CMV infection, as demonstrated by isolation of the virus within the first week of life, was diagnosed in 44 (0.5%) of 9806 infants. From this basic CMV-infected population, children who developed neurologic disturbances including sensorineural deafness before 1 year of age were excluded (n = 7), as were those unwilling to participate (n = 2). Congenitally infected infants (n = 35) and matched control infants (n = 53) were followed up clinically and neurologically. At 21 months, development was assessed with the Griffiths' Developmental Scale and at 7 years of age neurologic status was assessed with the Stott test and intellectual development with the Wechsler Intelligence Scale for Children.
As reported previously, 18% (8/44) of the CMV-infected infants manifested symptoms at birth, as compared to 8% (4/53) in the control group. In the congenital CMV group 7% (2/30) children tested had abnormal Stott test results, as compared to 2% (1/43) in the control group. Thirty-two CMV-infected and 51 control group children were assessed with the Griffiths' scale at 21 months of age. The two groups did not differ significantly, either in mean scores (6.3 +/- 2.3 vs 6.1 +/- 1.9) or in the proportion of children with scores below normal (19% [6/32] vs 16% [8/51]). Twenty-five CMV-infected and 41 control group children were assessed with the Wechsler Intelligence Scale for Children at 7 years of age (median 86 months; range, 82 to 90 and 82 to 91, respectively). The two groups did not differ significantly, either in mean scores (5.8 +/- 2.0 vs 6.4 +/- 1.6) or in the proportion of children with scores below normal (12% [3/25] vs 5% [2/41]).
Children with congenital CMV infection are unlikely to be at an increased risk of subsequent neurodevelopmental or intellectual impairment if they show normal development at 12 months of age.
本研究旨在确定出生时患有先天性巨细胞病毒（CMV）感染但1岁时无神经症状的儿童在长期随访中，其身体、神经、发育或智力状况与匹配的对照儿童是否存在差异。
在9806例婴儿中，44例（0.5%）在出生后第一周内病毒分离阳性，确诊为先天性CMV感染。在这个基本的CMV感染人群中，排除1岁前出现包括感音神经性耳聋在内的神经功能障碍的儿童（n = 7）以及不愿参与的儿童（n = 2）。对先天性感染婴儿（n = 35）和匹配的对照婴儿（n = 53）进行临床和神经学随访。在21个月时，用格里菲斯发育量表评估发育情况，在7岁时，用斯托特测试评估神经状况，用韦氏儿童智力量表评估智力发育。
如先前报道，CMV感染婴儿中有18%（8/44）在出生时出现症状，而对照组为8%（4/53）。先天性CMV感染组中7%（2/30）接受测试的儿童斯托特测试结果异常，而对照组为2%（1/43）。32例CMV感染儿童和51例对照组儿童在21个月时用格里菲斯量表进行评估。两组在平均得分（6.3±2.3对6.1±1.9）或得分低于正常的儿童比例（19%[6/32]对16%[8/51]）方面均无显著差异。25例CMV感染儿童和41例对照组儿童在7岁时用韦氏儿童智力量表进行评估（中位数86个月；范围分别为82至90个月和82至91个月）。两组在平均得分（5.8±2.0对6.4±1.6）或得分低于正常的儿童比例（12%[3/25]对5%[2/41]）方面均无显著差异。
如果先天性CMV感染儿童在12个月时发育正常，那么他们随后发生神经发育或智力损害的风险不太可能增加。
