Association Between Congenital Cytomegalovirus Infection and Brain Injury in Neonates: A Meta-analysis of Cohort Studies

Overview

Journal Behav Neurol

Publisher Wiley

Specialty Psychiatry

Date 2021 Oct 25

PMID 34691283

Citations 3

Authors

Li Zhang

Zhankui Li

Xiang Han

Hongyan Du

Yingli Cao

Yingmei Liu

Wenfeng Wang

Affiliations

Soon will be listed here.

Abstract

Objective: To assess association between congenital cytomegalovirus (CMV) infection and brain injury in neonates.

Methods: The literatures from inception to November 4, 2020, were searched through PubMed, Embase, Cochrane Library, and Web of Science. Heterogeneity test was conducted for each indicator and measured by statistics. If ≥ 50%, the random effects model was applied; otherwise, the fixed effects model was used. Sensitivity analysis was performed for all models. Weighed mean difference (WMD) was used as the effect size for measurement data, and risk ratio (RR) was as the effect indicator.

Results: A total of 13 studies, including 4,262 congenital CMV infection neonates, were enrolled in this study. Our results showed that the rate of hearing impairment (RR: 2.105, 95% CI: (1.115, 3.971), = 0.002), sensorineural hearing loss (SNHL) (RR: 17.051, 95% CI: (6.201, 46.886), < 0.001), and microcephaly (RR: 2.283, 95% CI: (1.325, 3.935), =0.003) in neonates infected congenital CMV was higher than that in control group.

Conclusion: The risks of hearing impairment, SNHL, and microcephaly in neonates during childhood may be associated with congenital CMV infection. It is necessary to establish neonatal screening programs and comprehensive diagnostic tests for patients to reduce the risk of adverse brain damage to the congenital CMV infection as early as possible and to improve the prognosis of the newborn.

Citing Articles

Cytomegalovirus and Pregnancy: A Narrative Review.

Pontes K, Nardozza L, Peixoto A, Werner H, Tonni G, Granese R J Clin Med. 2024; 13(2).

PMID: 38276146 PMC: 10816506. DOI: 10.3390/jcm13020640.

A systematic review of immune-based interventions for perinatal neuroprotection: closing the gap between animal studies and human trials.

Kelly S, Tran N, Polglase G, Hunt R, Nold M, Nold-Petry C J Neuroinflammation. 2023; 20(1):241.

PMID: 37864272 PMC: 10588248. DOI: 10.1186/s12974-023-02911-w.

Adipokines as Diagnostic and Prognostic Markers for the Severity of COVID-19.

Grewal T, Buechler C Biomedicines. 2023; 11(5).

PMID: 37238973 PMC: 10215701. DOI: 10.3390/biomedicines11051302.

References

Dreher A, Arora N, Fowler K, Novak Z, Britt W, Boppana S . Spectrum of disease and outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr. 2014; 164(4):855-9. PMC: 3982912. DOI: 10.1016/j.jpeds.2013.12.007. View

Yamamoto A, Mussi-Pinhata M, Isaac M, Amaral F, Carvalheiro C, Aragon D . Congenital cytomegalovirus infection as a cause of sensorineural hearing loss in a highly immune population. Pediatr Infect Dis J. 2011; 30(12):1043-6. PMC: 3222783. DOI: 10.1097/INF.0b013e31822d9640. View

Dollard S, Grosse S, Ross D . New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007; 17(5):355-63. DOI: 10.1002/rmv.544. View

Boppana S, Rivera L, Fowler K, Mach M, Britt W . Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N Engl J Med. 2001; 344(18):1366-71. DOI: 10.1056/NEJM200105033441804. View

Goderis J, De Leenheer E, Smets K, Van Hoecke H, Keymeulen A, Dhooge I . Hearing loss and congenital CMV infection: a systematic review. Pediatrics. 2014; 134(5):972-82. DOI: 10.1542/peds.2014-1173. View

Shapiro-Mendoza C, Rice M, Galang R, Fulton A, VanMaldeghem K, Prado M . Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy - U.S. Territories, January 1, 2016-April 25, 2017. MMWR Morb Mortal Wkly Rep. 2017; 66(23):615-621. PMC: 5657842. DOI: 10.15585/mmwr.mm6623e1. View

Klase Z, Khakhina S, de Bernardi Schneider A, Callahan M, Glasspool-Malone J, Malone R . Zika Fetal Neuropathogenesis: Etiology of a Viral Syndrome. PLoS Negl Trop Dis. 2016; 10(8):e0004877. PMC: 4999274. DOI: 10.1371/journal.pntd.0004877. View

Naing Z, Scott G, Shand A, Hamilton S, van Zuylen W, Basha J . Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention. Aust N Z J Obstet Gynaecol. 2015; 56(1):9-18. DOI: 10.1111/ajo.12408. View

Pathirana J, Texeira L, Munian H, Nakwa F, Mayet I, Maposa I . Neurological and growth outcomes in South African children with congenital cytomegalovirus: A cohort study. PLoS One. 2020; 15(9):e0238102. PMC: 7498063. DOI: 10.1371/journal.pone.0238102. View

10.

Ledger W . Perinatal infections and fetal/neonatal brain injury. Curr Opin Obstet Gynecol. 2008; 20(2):120-4. DOI: 10.1097/GCO.0b013e3282f734db. View

11.

Boppana S, Fowler K, Britt W, Stagno S, Pass R . Symptomatic congenital cytomegalovirus infection in infants born to mothers with preexisting immunity to cytomegalovirus. Pediatrics. 1999; 104(1 Pt 1):55-60. DOI: 10.1542/peds.104.1.55. View

12.

Bartlett A, McMullan B, Rawlinson W, Palasanthiran P . Hearing and neurodevelopmental outcomes for children with asymptomatic congenital cytomegalovirus infection: A systematic review. Rev Med Virol. 2017; . DOI: 10.1002/rmv.1938. View

13.

Santos D, Souza M, Goncalves S, Cotta A, Melo L, Andrade G . Congenital cytomegalovirus infection in a neonatal intensive care unit in brazil evaluated by PCR and association with perinatal aspects. Rev Inst Med Trop Sao Paulo. 2000; 42(3):129-32. DOI: 10.1590/s0036-46652000000300003. View

14.

Ahlfors K, Ivarsson S, Harris S, Svanberg L, Holmqvist R, Lernmark B . Congenital cytomegalovirus infection and disease in Sweden and the relative importance of primary and secondary maternal infections. Preliminary findings from a prospective study. Scand J Infect Dis. 1984; 16(2):129-37. DOI: 10.3109/00365548409087131. View

15.

Bradford R, Yoo Y, Golemac M, Pernjak Pugel E, Jonjic S, Britt W . Murine CMV-induced hearing loss is associated with inner ear inflammation and loss of spiral ganglia neurons. PLoS Pathog. 2015; 11(4):e1004774. PMC: 4395355. DOI: 10.1371/journal.ppat.1004774. View

16.

Adams Waldorf K, McAdams R . Influence of infection during pregnancy on fetal development. Reproduction. 2013; 146(5):R151-62. PMC: 4060827. DOI: 10.1530/REP-13-0232. View

17.

Britt W . Congenital Human Cytomegalovirus Infection and the Enigma of Maternal Immunity. J Virol. 2017; 91(15). PMC: 5512250. DOI: 10.1128/JVI.02392-16. View

18.

Zhang X, Li F, Yu X, Shi X, Shi J, Zhang J . Physical and intellectual development in children with asymptomatic congenital cytomegalovirus infection: a longitudinal cohort study in Qinba mountain area, China. J Clin Virol. 2007; 40(3):180-5. DOI: 10.1016/j.jcv.2007.08.018. View

19.

Jim W, Chiu N, Ho C, Shu C, Chang J, Hung H . Outcome of Preterm Infants With Postnatal Cytomegalovirus Infection via Breast Milk: A Two-Year Prospective Follow-Up Study. Medicine (Baltimore). 2015; 94(43):e1835. PMC: 4985402. DOI: 10.1097/MD.0000000000001835. View

20.

Fowler K, Boppana S . Congenital cytomegalovirus infection. Semin Perinatol. 2018; 42(3):149-154. DOI: 10.1053/j.semperi.2018.02.002. View