Birth prevalence and natural history of congenital cytomegalovirus infection in a highly seroimmune population.
BACKGROUND
The natural history of congenital cytomegalovirus (CMV) infection is scarcely known in populations with high maternal CMV seroprevalence. This study evaluated the birth prevalence, clinical findings at birth, and hearing outcome in CMV-infected children from such a population.


METHODS
Consecutively born infants were screened for the presence of CMV in urine and/or saliva specimens during the first 2 weeks after birth. Neonatal clinical findings were recorded, and CMV-infected children were tested to document hearing function during follow-up. A subset of mothers of CMV-infected infants were prenatally tested for the presence of anti-CMV immunoglobulin G antibodies.


RESULTS
Congenital CMV infection was confirmed in 87 (1.08%; 95% confidence interval [CI], 0.86%-1.33%) of 8047 infants. Seven infants (8.1%; 95% CI, 3.3%-15.9%) had at least 1 clinical finding suggestive of CMV infection, and 4 (4.6%; 95% CI, 1.3%-11.3%) had >3 findings of systemic disease. Sensorineural hearing loss was found in 5 (8.6%; 95% CI, 2.9%-19.0%) of 58 children tested at a median age of 21 months. Bilateral profound hearing loss was observed in 2 children, and the hearing threshold was >60 decibels in all 5 children with hearing loss, including 2 children born to mothers with probable nonprimary CMV infection.


CONCLUSIONS
The results of this large newborn screening study in a population with high CMV seroimmunity provide additional evidence that congenital CMV disease occurs in populations with high seroprevalence rates, with a similar incidence of CMV-related hearing loss to that reported in the offspring of women from populations in developed countries with lower rates of seroimmunity to CMV.
Mussi-Pinhata
Marisa M
MM
Department of Pediatrics, University of São Paulo, Avenida Bandeirantes 3900, 14049-900, Ribeirão Preto, SP, Brazil. mmmpinha@fmrp.usp.br
Yamamoto
Aparecida Y
AY
Moura Brito
Rosângela M
RM
de Lima Isaac
Myriam
M
de Carvalho e Oliveira
Patricia F
PF
Boppana
Suresh
S
Britt
William J
WJ
D000328:Adult; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D005260:Female; D006320:Hearing Tests; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D012463:Saliva / Q000821:virology; D014556:Urine / Q000821:virology; D055815:Young Adult