Differential congenital cytomegalovirus infection in dichorionic diamniotic twins—A case report and literature review

Feng, Shuwen; Pin, Liu; Yang, Pu; Zhao, Dongchi

doi:10.1016/j.idcr.2022.e01373

Cited by 3 publications

(3 citation statements)

References 15 publications

(18 reference statements)

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“…1). Study characteristics appear in Table 2 (11–41). The systematic review included 18 single-case reports, 6 case series, 5 cohort/cross-sectional studies, and 1 pre-post intervention study.…”

Section: Resultsmentioning

confidence: 99%

Congenital Cytomegalovirus Infection and Hearing Outcomes in Twins: A Systematic Review of Reported Cases

Cordray¹,

Liu-Lam

Tey³

et al. 2022

Otol Neurotol

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ObjectiveCongenital cytomegalovirus infection is the leading nonhereditary cause of pediatric sensorineural hearing loss. This systematic review evaluated infection concordance and comparative hearing abilities in twins/multiple births to model infection patterns.Databases ReviewedPubMed, Embase, Web of Science, and Google Scholar.MethodsStudies that reported hearing outcomes of congenital cytomegalovirus infection in at least one multiple birth were eligible. Concordant infections (both twins) and discordant infections (single twin) were included. Multiple reviewers performed data extraction and quality assessment. Analyses involved relative risk of infection concordance by zygosity and chorionicity and odds of hearing loss by infection concordance. Hearing outcomes were compared between siblings.ResultsOf 247 studies screened, 31 were included (74.2% high quality). The review captured 40 eligible multiple births. Among infected patients, 42.9% (95% confidence interval, 31.2–55.2%) demonstrated hearing loss. All uninfected twins had normal hearing. Most infections were concordant, and infected patients experienced 4.11 (1.18–14.36) times greater odds of hearing loss if their twin was also infected (p = .02). Yet siblings’ hearing outcomes diverged in over 40% of concordant cases. If either twin is infected, infection risk in the second twin is 3.25 (1.83–5.79) times greater in monozygotic than dizygotic twins and 2.50 (1.61–3.88) times greater in monochorionic than dichorionic twins (both p < .001). We describe a case from our practice.ConclusionCongenital cytomegalovirus infection patterns and hearing outcomes can vary widely even within a shared fetal and postnatal environment. Suspected infection in a twin indicates that both should receive testing and continued monitoring for late-onset sequelae.

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Section: Resultsmentioning

confidence: 99%

Congenital Cytomegalovirus Infection and Hearing Outcomes in Twins: A Systematic Review of Reported Cases

Cordray¹,

Liu-Lam

Tey³

et al. 2022

Otol Neurotol

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“…Eine diskordante Virustransmission und der unterschiedliche klinische Verlauf wurden bei Zwillingsschwangerschaften bisher nur in Einzelfällen beschrieben [20,21,22]. Zwillingsschwangerschaften werden in dichorial-diamniale (Di/Di), monochorialdiamniale (Mo/Di) und monochorial-monoamniale (Mo/Mo) geteilt.…”

Section: Diskussion/fazit Für Die Praxisunclassified

“…Es können beide Zwillinge infiziert sein oder nur der eine Fetus, die klinischen Symptome und Prognose sind unterschiedlich. Di/Di-Gemini haben eine größere Wahrscheinlichkeit einer diskordanten Infektion (52,9%) als Mo/Di-Zwillinge [22]. Die Blutübertragung ist der wahrscheinlichste Übertragungsweg, der zur Ausbreitung der CMV-Infektion führt, und durch die Nabelschnur gelangt sie in den fetalen Kreislauf.…”

Section: Diskussion/fazit Für Die Praxisunclassified

Unterschiedliche Virustransmission und klinischer Verlauf einer Zytomegalievirus-Infektion bei dichorialer Geminigravidität

Kirov,

Alsat-Krenz,

Enders

et al. 2024

Geburtshilfe Frauenheilkd

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Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns

Marin,

dos Santos,

Ramos

et al. 2024

Virol J

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Background Cytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss. Methods This study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test. Results CMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays. Conclusions The prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections.

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Differential congenital cytomegalovirus infection in dichorionic diamniotic twins—A case report and literature review

Cited by 3 publications

References 15 publications

Congenital Cytomegalovirus Infection and Hearing Outcomes in Twins: A Systematic Review of Reported Cases

Congenital Cytomegalovirus Infection and Hearing Outcomes in Twins: A Systematic Review of Reported Cases

Unterschiedliche Virustransmission und klinischer Verlauf einer Zytomegalievirus-Infektion bei dichorialer Geminigravidität

Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns

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