Prenatal findings, neonatal symptoms and neurodevelopmental outcome of congenital cytomegalovirus infection in a university hospital in Montreal, Quebec
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Abstract
Background
Outcome of congenital cytomegalovirus (cCMV) infection in the absence of routine CMV screening and third-trimester scan in North America is scarcely documented. The aim of this study was to assess the severe outcomes related to cCMV according to the indication for screening.
Methods
This was a retrospective study of 84 mother-child pairs followed for cCMV between 2003 and 2017 at CHU Sainte-Justine in Montreal, Canada. Prenatal ultrasound, neonatal symptoms, neuroimaging and severe outcomes (cerebral palsy, severe cognitive impairment, bilateral hearing loss or neonatal death) were reviewed.
Results
Among 38 cases with abnormal prenatal ultrasound, 41.9% of live-born infants developed severe outcomes. Sixteen (42.1%) were detected in the third trimester. Among 16 cases diagnosed prenatally because of maternal history, all had normal prenatal ultrasound, and none developed severe outcomes. Among cases diagnosed postnatally because of neonatal symptoms, 25% developed severe outcomes. All infants who developed severe outcomes had moderate/severe neonatal symptoms.
Conclusion
Outcome of cCMV infection varies according to the reason for screening and timing of diagnosis. Any prenatal ultrasound anomaly might indicate a risk of severe outcome, and warrants a detailed ultrasound scan. However, late detection, or postnatal diagnosis, represented more than half of the cases, and awareness of this will help ensuring optimal management.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: Funder Name: Fonds de Recherche du Québec – Santé, Funder Id: http://dx.doi.org/10.13039/501100000156, Awarded to Fatima Kakkar and Isabelle Boucoiran.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2019-0331).
©2020 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Corner of Academy
- Operative vaginal delivery: a review of four national guidelines
- Mini Review
- Drug exposure during pregnancy and fetal cardiac function – a systematic review
- Original Articles – Obstetrics
- Pregnancy outcomes among women with peptic ulcer disease
- The effect of placental elasticity on intraoperative bleeding in pregnant women with previous cesarean section
- Cellular immune responses in amniotic fluid of women with preterm prelabor rupture of membranes
- Prenatal findings, neonatal symptoms and neurodevelopmental outcome of congenital cytomegalovirus infection in a university hospital in Montreal, Quebec
- Maternal obesity influences the endocrine cord blood profile of their offspring
- Value of cervicovaginal fluid cytokines in prediction of fetal inflammatory response syndrome in pregnancies complicated with preterm premature rupture of membranes (pPROM)
- Reliability of strain elastography using in vivo compression in the assessment of the uterine cervix during pregnancy
- Original Articles – Fetus
- Comparison of strain and dyssynchrony measurements in fetal two-dimensional speckle tracking echocardiography using Philips and TomTec
- Quantitative measurements of celeration times and indexes in the ductus venosus spectral Doppler waveforms in normal fetuses
- Original Articles – Newborns
- Evaluation of cerebral oxygenation and perfusion in small for gestational age neonates and neurodevelopmental outcome at 24–36 months of age
- Measurement of inotropy and systemic oxygen delivery in term, low- and very-low-birth-weight neonates using the Ultrasonic Cardiac Output Monitor (USCOM)
- Short-term neurological improvement in neonates with hypoxic-ischemic encephalopathy predicts neurodevelopmental outcome at 18–24 months
