The Multifaceted Clinical Characteristics of Congenital Cytomegalovirus Infection: From Pregnancy to Long-Term Outcomes

• DOI: 10.3346/jkms.2023.38.e249
• Publication Date: 2023-07-27T05:05:24Z
• Authors: Yejin Kim; Yoo-min Kim; Doo Ri Kim; Han Gyeol Kim; Ji-Hee Sung; Suk-Joo Choi; Soo-young Oh; Yae-Jean Kim; Yun Sil Chang; Dongsub Kim; Jung-Sun Kim; Il Joon Moon; Cheong-Rae Roh
• Keywords: Valganciclovir; Cytomegalovirus; Ventriculomegaly

The aim of this study was to capture multifaceted clinical characteristics congenital cytomegalovirus (CMV) infection from diagnosis treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head neck surgery.This is retrospective 30 consecutive cases CMV that were diagnosed at single tertiary hospital located in Seoul, Korea January 2009 December 2020. Congenital defined as positive result by polymerase chain reaction urine, saliva or cerebrospinal fluid IgM neonatal blood sampled within 3 weeks after birth. All analyzed with respect whole prenatal sonographic findings, maternal immune status regarding infection, detailed placental manifestation, auditory brainstem response test, antiviral (ganciclovir valganciclovir). Long-term outcomes developmental delay hearing loss also investigated.The total number births during the period our institution 19,385, prevalence estimated be 0.15%. Among CMV, median gestational age delivery 32.2 [range, 22.6-40.0] 66.7% these infants delivered preterm less than 37 weeks. Suspected fetal growth restriction most common ultrasound finding (50%) followed ventriculomegaly (17.9%) abnormal placenta (17.9%), thick calcification. No findings on examination observed one-third births. Maternal serology tests conducted only 8 cases, one case each equivocal found. pathologic chronic villitis (66.7%) calcification (63.0%), whereas viral inclusions identified 22.2%. manifestations jaundice (58.6%) elevation aspartate aminotransferase (55.2%) thrombocytopenia (51.7%). After excluding for which long-term unavailable due death (n = 4) subsequent follow up 3), confirmed 43.5% (10/23), 42.9% (9/21) follow-up period. In cohort, 56.7% (17/30) neonates treated ganciclovir valganciclovir.Our data show serologic have limited ability detect Korea. Given associated high rates infants, there an urgent need develop specific strategies definite perinatal decrease risks neurologic impairment through early treatment.