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Cytomegalovirus congenital infection: long-term outcomes in a valaciclovir treated population

  • Maria Vicente EMAIL logo , Ana I. Carocha , Claúdia Rijo , Álvaro Cohen and Maria L. Martins
Published/Copyright: July 1, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 7

Abstract

Objectives

This case series aims to evaluate the long-term outcomes of congenital cytomegalovirus (CMV) infection in a population treated with valaciclovir during pregnancy. The study focuses on assessing the prevalence of long-term sequelae in infants with confirmed CMV fetal infection.

Methods

A retrospective analysis was conducted on 33 pregnancies corresponding to 34 fetus with confirmed CMV congenital infection. They were followed from November 2004 to December 2020. Valaciclovir treatment was initiated after confirmation of fetal infection, and fetal outcomes were monitored through serial ultrasounds, neurosonography, and fetal magnetic resonance imaging (MRI). Postnatal assessments included: PCR confirmation, symptoms evaluation at birth, and long-term follow-up protocols for visual, auditory, and neurodevelopmental assessment.

Results

Therapy was started at a median gestational age of 24 weeks. Of the 34 newborns 79.4 % were asymptomatic at birth. Median follow-up time was 6 years and 32.35 % developed long-term sequelae. Neurosensorial hearing loss (SNHL) was the predominant sequelae. In the cases which developed sequelae 54.5 % had imaging findings, and all with major findings developed long-term sequelae.

Conclusions

In our treated population we had a higher asymptomatic rate at birth comparing with a non-treated population, similar to those found in previous studies. We had a long-term sequelae rate of 32.35 %, similar to recent studies on non-treated population, although we registered a slightly lower rate of SNHL. A larger multicenter studies with a longer follow-up time, where treatment is started in the first trimester, is of the utmost importance, so we can truly understand the correlation between these imaging findings, therapy and long-term sequelae.

Keywords: congenital cytomegalovirus; secondary prevention; valaciclovir treatment; long-term outcomes
Corresponding author: Maria Vicente, Fetal Medicine and Surgery Department, Maternidade Dr. Alfredo da Costa – Unidade Local de Saúde de São José, Rua Viriato 1, 2890-495 Lisboa, Portugal, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: Not applicable.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2023-0535).

Received: 2023-12-15
Accepted: 2024-05-18
Published Online: 2024-07-01
Published in Print: 2024-09-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpm-2023-0535
Keywords for this article
congenital cytomegalovirus; secondary prevention; valaciclovir treatment; long-term outcomes

Articles in the same Issue

  1. Frontmatter
  2. Corner of Academy
  3. The IAPM New York 2024 declaration on professional responsibility and abortion
  4. Review
  5. Common foot and ankle disorders in pregnancy: the role of diagnostic ultrasound
  6. Opinion Paper
  7. Reproductive genetic carrier screening in pregnancy: improving health outcomes and expanding access
  8. Original Articles – Obstetrics
  9. “It feels like you have to choose one or the other”: a qualitative analysis of obstetrician focus groups on periviability counseling
  10. Expectant management vs. cerclage in cases with prolapsed or visible membranes in the second trimester: is 24 weeks gestation threshold critical?
  11. Prevention of preterm birth in twin-to-twin transfusion syndrome: a systematic review and network meta-analysis
  12. Accidental uterine extensions in cesarean deliveries – outcome of subsequent pregnancy
  13. Effect of acidic vaginal pH on the efficacy of dinoprostone (PGE2) vaginal tablet for labor induction in full term pregnant women: a randomized controlled trial
  14. Oligohydramnios at term in the high-risk population – how severe is severe?
  15. Original Articles – Fetus
  16. Assessment of the fetal thymic-thoracic ratio in pregnant women with intrahepatic cholestasis: a prospective case-control study
  17. Congenital diaphragmatic hernia treated via fetal endoscopic tracheal occlusion improves outcome in a middle-income country
  18. Fetal bradyarrhythmias: classification, monitoring and outcomes of 40 cases at a single center
  19. Deep learning based detection and classification of fetal lip in ultrasound images
  20. Original Articles – Neonates
  21. Cytomegalovirus congenital infection: long-term outcomes in a valaciclovir treated population
  22. Does placental VEGF-A protein expression predict early neurological outcome of neonates from FGR complicated pregnancies?
  23. Letters to the Editor
  24. Why do women choose home births: correspondence
  25. Enhancing safety and outcomes in home births: a detailed response to concerns and recommendations
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