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1.
An. pediatr. (2003. Ed. impr.) ; 98(1): 41-47, ene. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-214785

RESUMO

Introducción: El citomegalovirus (CMV) es una de las infecciones congénitas más frecuentes, con una prevalencia del 0,3-2,4%. En España, al no formar parte del cribado gestacional, se realiza screening de los recién nacidos con factores de riesgo y, en muchos centros, de los que presentan bajo peso para la edad gestacional (BPEG). Para ello se realiza, generalmente, determinación de Polymerase Chain Reaction (PCR) del virus en orina y/o ecografía transfontanelar en busca de imágenes compatibles. El objetivo del estudio es evaluar el rendimiento de la PCR de CMV en orina y ecografía transfontanelar, en recién nacidos >34 semanas asintomáticos, sin factores de riesgo, con BPEG. El objetivo secundario es evaluar el coste-efectividad. Material y métodos: Estudio observacional, descriptivo y retrospectivo, entre enero y diciembre de 2019, en un hospital de tercer nivel (IIIC). Incluye recién nacidos >34 semanas, sin factores de riesgo con BPEG, con PCR de CMV en orina y/o ecografía transfontanelar realizada. (AU)


Introduction: Infection by cytomegalovirus (CMV) is one of the most common congenital infections, with a global prevalence of 0.3%-2.4%. In Spain, CMV screening is not performed during pregnancy, but rather in neonates with risk factors, and, in many hospitals, in those born small for gestational age (SGA). Screening is usually performed by measurement of the viral load in urine by polymerase chain reaction (PCR) and/or head ultrasound in search of compatible features. The aim of the study was to assess the yield of the CMV PCR test in urine and head ultrasound examination in asymptomatic neonates born SGA after 34 weeks’ gestation. The secondary objective was to assess the cost-effectiveness of this strategy. Design and methods: We conducted an observational and retrospective study between January and December 2019 in a tertiary care hospital. It included neonates delivered after 34 weeks, SGA and without additional risk factors assessed with a CMV PCR test in urine and/or head ultrasound. (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Citomegalovirus , Programas de Rastreamento , Neonatologia , Epidemiologia Descritiva , Estudos Retrospectivos , Idade Gestacional
2.
An Pediatr (Engl Ed) ; 98(1): 41-47, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36528494

RESUMO

INTRODUCTION: Infection by cytomegalovirus (CMV) is one of the most common congenital infections, with a global prevalence of 0.3%-2.4%. In Spain, CMV screening is not performed during pregnancy, but rather in neonates with risk factors, and, in many hospitals, in those born small for gestational age (SGA). Screening is usually performed by measurement of the viral load in urine by polymerase chain reaction (PCR) and/or head ultrasound in search of compatible features. The aim of the study was to assess the yield of the CMV PCR test in urine and head ultrasound examination in asymptomatic neonates born SGA after 34 weeks' gestation. The secondary objective was to assess the cost-effectiveness of this strategy. DESIGN AND METHODS: We conducted an observational and retrospective study between January and December 2019 in a tertiary care hospital. It included neonates delivered after 34 weeks, SGA and without additional risk factors assessed with a CMV PCR test in urine and/or head ultrasound. RESULTS: The sample included 259 patients. It was divided in 2 groups: group 1, patients with a head circumference, weight and length below the 10th percentile (53 patients; 20.5%), and group 2, patients in whom only the weight was below the 10th percentile (206 patients; 79.5%). The incidence of late preterm birth, twin pregnancy, neonatal admission and exposure to illicit drugs during gestation was higher in group 1. A total of 186 urine PCR tests and 223 head ultrasounds were performed overall, and both tests were performed more frequently in group 1 (P=.002). There was only 1 positive CMV PCR test result in the sample (0.54%), corresponding to a patient in group 2 with no abnormal sonographic findings who remained asymptomatic throughout the follow-up. Two head ultrasound examinations yielded abnormal findings, in both cases unrelated to congenital CMV infection. We performed a cost-effectiveness analysis and determined that the cumulative cost of head ultrasound examinations and urine CMV PCR tests in our sample amounted to Є17 000 for the detection of a single asymptomatic positive case. CONCLUSION: In our population, screening for congenital CMV infection in asymptomatic late preterm and term newborns whose only risk factor is SGA does not seem to be cost effective. It would be necessary to expand the sample to other populations.


Assuntos
Infecções por Citomegalovirus , Doenças do Recém-Nascido , Nascimento Prematuro , Gravidez , Feminino , Recém-Nascido , Humanos , Citomegalovirus , Análise Custo-Benefício , Idade Gestacional , Estudos Retrospectivos , Recém-Nascido Pequeno para a Idade Gestacional , Retardo do Crescimento Fetal/etiologia , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/congênito
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