Congenital cytomegalovirus infection in very low birth weight neonates

Authors

Keywords:

congenital cytomegalovirus, cytomegalovirus, very low birth weight neonate

Abstract

Introduction: Congenital cytomegalovirus infection in neonates weighing less than 1500 grams can be a cause of morbidity, mortality, and disability. 

Objective: To describe the behavior of congenital cytomegalovirus infection in a neonatal service. 

Methods: A descriptive and cross-sectional study was conducted with 61 neonates. Cytomegalovirus was detected in the first week of life in serum and urine, by polymerase chain reaction, to determine congenital infection. Perinatal variables were evaluated in all neonates, as well as clinical elements and results of complementary examinations in infected infants. 

Results: The incidence of congenital infection was 10% (6/61). 5% of the studies were positive (6/122). No urine samples were positive (0/61) and the virus genome was detected in 10% of serum samples (6/61). An association was found between nutritional assessment at birth and cytomegalovirus infection (p < 0.05). A total of 83% of infected neonates had some clinical sign, with respiratory distress syndrome being the most common (67%). In all neonates with congenital infection, brain ultrasound was normal, and retinopathy of prematurity was detected in 33% of patients with fundus retinopathy. 

Conclusions: The incidence of congenital cytomegalovirus infection is high in this risk group. The clinical signs found and the results of the fundus in neonates with congenital infection were related to prematurity and the nutritional assessment of hypotrophic was associated with this infection.

Downloads

Download data is not yet available.

Author Biography

Tania Roig Álvarez, Centro de Investigaciones clínicas

Especialista de Segundo Grado en Neonatología, Doctora en Ciencias Médicas, Master en Infectología y enfermedades tropicales, Profesora e Investigadora Titular.

References

1. American Academy of Pediatrics. Cytomegalovirus Infection. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (eds). Red Book:2021. Report of the Committee on Infectious Diseases. Illinois: American Academy of Pediatrics; 2021. p 294-301.

2. Revello MG, Gerna G. Diagnosis and management of Human Cytomegalovirus infection in the mother, fetus and newborn infant. Clin Microbiol Rev. 2002;15(4): 680-715. DOI: 10.1128/CMR.15.4.680-715.2002

3. Ronchi A, Pugni L, Mosca F. Cytomegalovirus Infection. In: Cantey JB (ed). Neonatal Infections. Pathophysiology, Diagnosis, and Management. Texas: Springer; 2018. p. 83-93.

4. Correa CB, Kouri V, Verdasquera D, Martinez PA, Álvarez A, Alemán Y, et al. HCMV seroprevalence and associated risk factors in pregnant women, Havana City, 2007 to 2008. PrenatDiagn. 2010;30:888-92. DOI: 10.1002/pd.2587.

5. Kourí V, Correa CB, Verdasquera D, Martinez PA, Álvarez A, Alemán Y, et al. Diagnosis and Screening for Cytomegalovirus Infection in Pregnant Women in Cuba as Prognostic Markers of Congenital Infection in Newborns: 2007–2008. PediatrInfectDis J 2010;29(12):1105-10. DOI: 10.1097/INF.0b013e3181eb7388

6. Festary A, Kourí V, Correa CB, Verdasquera D, Roig T, Couret MP. Cytomegalovirus and Herpes Simplex Infections in Mothersand Newborns in a Havana Maternity Hospital. MEDICC Review. 2015;17(1):29-34. DOI: 10.37757/MR2015.V17.N1.7

7. Tenorio A, Echevarría JE, Casas I, Echevarría JM, Tabarés E. Detection and typing of human herpesviruses by multiplex polimerase chain reaction. J Virol Methods. 1993; 44:261-9. DOI: 10.1016/0166-0934(93)90061-u

8. Wang S, Wang T, Zhang W, Liu X, Wang X, Wang H, et al. Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China. Medicine. 2017;96(5):e6007. DOI: 10.1097/MD.0000000000006007

9. Putri ND, WiyatnoA, Dhenni R, Sriyani IY, Dewantari AK, Handryastuti S, et al. Birth prevalence and characteristics of congenital cytomegalovirus infection in an urban birth cohort, Jakarta, Indonesia . Inter J Infect Dis. 2019;86:31-9. DOI: 10.1016/j.ijid.2019.06.009

10. Lee CY, Lin KY, Chen TH, Sung CH, Yu Ping Fang YP, Sung PL, et al. Prevalence of cytomegalovirus DNAemia and genotypic distribution among childbearing mothers and neonates in Taiwan. Inter J Infect Dis. 2020;91:240-5. DOI: 10.1016/j.ijid.2019.11.025

11. Chuang A, Ramos H, Zelada, López MT, Villavicencio L, Montecinos L, et al. Cribado de infección por citomegalovirus congénito en recién nacidos de alto riesgo. Rev Chilena Infectol. 2021;38(1):45-53. DOI: 10.4067/S0716-10182021000100045

12. Tran C, Bennett MV, Gould JB, Lee HC, Lanzieri TM. Cytomegalovirus Infection among Infants in Neonatal Intensive Care Units, California, 2005–2016. Am J Perinatol. 2020;37(2):146-50. DOI: 10.1055/s-0039-1683958

13. Rawlinson WD, Boppana SB, Fowler KB, Kimberlin DW, Lazzarotto T, Alain S, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis. 2017;17:e177-88. DOI: 10.1016/S1473-3099(17)30143-3

14. Lin C, Tomio J, Tanaka H, Sonoda M, Sano K,Kobayashi Y. Diagnosis and medical care for congenital cytomegalovirus infection: an observational study using claims data in Japan, 2010–2017. Medicine.2020;99(10):e19419. DOI: 10.1097/MD.0000000000019419.

15. Kobas M Bickle GM, Truttmann AC, Giannoni E, Meylan P, Asner SA. Clinical characteristics, audiological and neurodevelopmental outcomes of newborns with congenital cytomegalovirus infection. Swiss Med Wkly. 2019;149:W20075. DOI: 10.4414/smw.2019.20075

16. Nijman J, Mandemaker FS, Verboon-Maciolek MA, Aitken SC, van Loon AM, et al. Genotype Distribution, Viral Load and Clinical Characteristics of Infants with Postnatal or Congenital Cytomegalovirus Infection. PLoS ONE. 2014;9(9):e108018. DOI: 10.1371/journal.pone.0108018

17. Álvarez Domínguez E, Figueras Aloy J, Botet Mussons F, Marcos Maeso MA, Pérez Fernández JM. Screening for cytomegalovirus infection in very low birth weight infants. An Pediatr (Barc). 2013;79(1):3-9. DOI: 10.1016/j.anpedi.2012.09.018

18. Turner KM, Lee HC, Boppana SB, Carlo WA, Randolph DA. Incidence and impact of CMV infection in very low birth weight infants. Pediatrics. 2014;133(1):e609-15. DOI: 10.1542/peds.2013-2217.

Published

2024-02-23

How to Cite

1.
Roig Álvarez T, Kourí Cardellá V, Correa Sierra C, Baños Morales Y, Barrios Rentería Y, Arencibia Borroto T, et al. Congenital cytomegalovirus infection in very low birth weight neonates. Rev Cubana Pediatría [Internet]. 2024 Feb. 23 [cited 2025 Jul. 3];96. Available from: https://revpediatria.sld.cu/index.php/ped/article/view/4390

Issue

Section

NEONATOLOGÍA