Congenital cytomegalovirus infection among preterm and full-term newborn infants in a neonatal intensive care unit

ABSTRACT

Cytomegalovirus [CMV] is the most common cause of congenital infections in human. The aim of the present study was to determine the prevalence and the clinical manifestations of congenital CMV infection among preterm and full-term newborn infants under intensive care and to correlate this infection with some features linked to the infants and their mothers. Serum samples were taken from 90 newborn infants [including 47 preterm and 43 full-term infants] and from their mothers, and were subjected to testing for IgM antibodies to CMV [CMV-IgM] by ELISA test. Sera from the mothers were also tested for IgG antibodies to CMV [CMV-IgG] by ELISA test. In addition, urine samples were taken from the newborns and were investigated for the presence of CMV DNA by nested polymerase chain reaction. It was found that 16 of the 90 newborns [17.8%] had congenital CMV infection, [all of them were positive for both CMV-IgM in serum and CMV DNA in urine] including 11[12.2%] preterm and 5[5.6%] full-term infants, with a significantly higher prevalence of infection among preterm infants [P<0.05]. On comparing between preterm and full-term newborn infants with congenital CMV infection, no significant difference in sex was found between both groups of infants [P> 0.05], but the gestational age and the birth weight were significantly higher in infected full-term infants [P< 0.05], while the presence of symptomatic CMV infection at birth was significantly more frequent in infected preterm infants [P< 0.05]. This symptomatic infection was found in 7 of the 16[43.8%] congenitally infected infants, including 6[37.5%] preterm infants and 1[6.3%] full-term infant. The main clinical manifestations of this symptomatic infection were low birth weight, jaundice, hepatosplenomegaly, anaemia, thrombocytopenia, purpura and microcephaly. Furthermore, on comparing between newborn infants with and without congenital CMV infection for features related to the newborns and their mothers, no significant difference was found between these two groups of infants concerning sex, gestational age, birth weight, maternal age or parity [P> 0.05], but maternal CMV-IgG seropositivity was significantly more frequent among infected newborns' mothers [P< 0.01], while maternal prenatal care reception was significantly more frequent among non infected newborn's mothers [P<0.01]. Screening newborns under intensive care for congenital CMV infection is recommended to allow for early treatment of symptomatic cases and follow-up of asymptomatic ones, giving the chance for better prognosis for these infected infants. Adequate prenatal care is also recommended to decrease the risk of transmission of CMV infection from infected pregnant mothers to their fetuses and to reduce infants' perinatal mortality from this infection