Original ArticlesCongenital Cytomegalovirus among Children with Cerebral Palsy
Section snippets
Methods
Parents or guardians of children (aged less than 18 years) with CP (birth years 1996-2014) from the NSW and ACT CP registers, or the state-wide disability services provider Cerebral Palsy Alliance, or the CP outpatient clinic at the Children's Hospital at Westmead, provided informed consent for NBSC testing for cCMV and extraction of registry data. This study was approved by the NSW Population and Health Services Research Ethics Committee (EC00410), the Cerebral Palsy Alliance Human Research
Results
A total of 401 individuals with CP were recruited, of whom 323 (80.5%) had an available NBSC (Figure; available at www.jpeds.com). Of these, 31 (9.6%; 95% CI, 6.8-13.3) tested positive for CMV DNA (cCMV-positive cases) in NBSC by nested PCR for CMV gB, of whom 28 (8.7%; 95% CI, 6.1-12.2) had CMV DNA also detected by real time PCR for CMV UL83.
We next compared the characteristics of participants using extracted registry data, according to their NBSC test result for CMV DNA. There were 140 female
Discussion
This retrospective study identified that 9.6% (95% CI, 6.8%-13.3%) of children with CP had CMV DNA detected in their NBSC, confirming cCMV infection. This proportion is markedly higher than the proportion of children with CMV detected in the newborn period in the general community (approximately 0.6%).2, 16 It is also 6 times greater than the proportion of children with CP who have cCMV reported as an attributable cause to the ACPR (1.5%),9 and in a recent retrospective study of Caucasian
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2022, American Journal of Obstetrics and GynecologyCitation Excerpt :Congenital cytomegalovirus (CMV) infection is the leading infectious cause of congenital malformations, stillbirth, sensorineural hearing loss, and neurodevelopmental impairment in developed countries.1 It is also a major preventable cause of cerebral palsy, implicated in 10% of affected children.2 The fetal brain is especially vulnerable to injury from CMV infection because of the viral tropism for neural progenitor cells, mediated by both the direct cytotoxic effects of viral replication and bystander damage because of inflammation and microglial cell activation.3
The long-term burden of congenital cytomegalovirus: Hospitalisation and mortality in a population-based matched cohort study
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Neonatal encephalopathy: Focus on epidemiology and underexplored aspects of etiology
2021, Seminars in Fetal and Neonatal MedicineCitation Excerpt :We recommend documentation of testing performed during pregnancy. CMV is the most common congenital infection in developed countries, can present as NE[43] and may be on the pathway to CP for up to 10%. [44]. Since postnatal antiviral treatment is available, this is an important infection to recognize.
Is it time to adopt routine cytomegalovirus screening in pregnancy? No!
2021, American Journal of Obstetrics and Gynecology MFMCitation Excerpt :Congenital cCMV infection is now more common in live infants than Down syndrome, fetal alcohol syndrome and neural tube defects.7 In Australia, 1 in 10 children with cerebral palsy (CP) have virological evidence of cCMV infection, making it the most common preventable cause of CP.8 In fact, a recent economic model estimated the cost of cCMV infection in the United Kingdom to be around £732 million, largely because of the long-term costs of neurodisability.9
Funded by National Health and Medical Research Council (Dora Lush Public Health Scholarship 1055901 [to H.S.-S.] and Career Development Fellowship 1087062 [to C.R.-G.]), Rebecca L. Cooper Medical Research Foundation ([to H.S.-S., C.J., A.K., N.B], Cerebral Palsy Alliance Research Foundation [to H.S.-S., C.R.-G., C.J., A.K., N.B.], Sydney Medical School Foundation [to H.S.-S., C.J.]. The authors declare no conflicts of interest.
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Current affiliation: Westmead Institute for Medical Research, Westmead, New South Wales, Australia.