ABSTRACT
OBJECTIVE: We evaluated the neuropsychological outcome of children with proven congenital cytomegalovirus (CMV) infection and normal consecutive fetal neurosonographic examinations. METHODS: We retrospectively reviewed laboratory and imaging findings of children with congenital CMV infection. The study group consisted of children with a positive polymerase chain reaction (PCR) in amniotic fluid and virus isolation in urine in the first week of life, and normal fetal ultrasonographic (US) examination findings, including a normal multiplanar neurosonographic evaluation. Patients with abnormal magnetic resonance (MR) findings were not excluded. The study and control groups were evaluated for cognitive, language, and motor development at one follow-up examination conducted at 11-81 months of age. RESULTS: Children with congenital CMV infection and normal fetal brain findings in the US examination did not differ from the control group in terms of cognitive, language, motor, emotional-behavioral, and executive functioning. There were no differences between congenitally infected children who had a normal fetal brain MR examination and children whose fetal brain MR examination raised suspicion of a possible brain insult. CONCLUSIONS: Normal neurosonographic examinations during pregnancy appear to predict a normal early neuropsychological outcome in fetuses with congenital CMV infection. Outcome did not correlate with suspected abnormal white matter on fetal MR imaging.
Subject(s)
Brain/embryology , Cytomegalovirus Infections/diagnostic imaging , Echoencephalography , Mental Disorders/diagnostic imaging , Pregnancy Complications, Infectious/diagnostic imaging , Ultrasonography, Prenatal , Algorithms , Brain/pathology , Case-Control Studies , Child , Child, Preschool , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/pathology , Female , Humans , Infant , Infant, Newborn , Male , Mental Disorders/complications , Mental Disorders/pathology , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Prognosis , Retrospective Studies , Ultrasonography, Prenatal/standardsABSTRACT
Cytomegalovirus (CMV) infection is the most common viral cause of congenital infection and one of the most common contributors to neurodevelopmental disabilities in children. The physiological condition of the infants at birth is a good predictor of long-term cognitive functioning, while children who manifest clinical symptoms at birth (symptomatic) are more likely to develop future cognitive impairments. Brain imaging studies from prenatal diagnosed children are scant, focusing mainly on fetuses with brain signs of CMV infection. While several studies demonstrate a poor outcome for children with neurosonographic findings during pregnancy, a systematic investigation regarding long-term neurodevelopmental outcome of fetuses infected with CMV, but without fetal ultrasonographic brain findings, has not been reported.
