Impaired balance and neurodevelopmental disabilities among children with congenital cytomegalovirus infection

Karltorp, Eva; Löfkvist, Ulrika; Lewensohn-Fuchs, Ilona; Lindström, Karin; Westblad, Mimmi Eriksson; Fahnehjelm, Kristina Teär; Verrecchia, Luca; Engman, Mona-Lisa

doi:10.1111/apa.12745

Cited by 51 publications

(86 citation statements)

References 23 publications

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“…Karltorp et al [2014] observed a higher association with cognitive impairment in children with CMV-induced HL than in those with HL caused by GJB2 mutations. Thus, systematic CMVpi screening may improve their management, and a long-term follow-up of a large cohort of newborns with CMVpi would provide better understanding of the impact on cognitive development.…”

Section: Discussionmentioning

confidence: 73%

Unilateral Sensorineural Hearing Loss: Medical Context and Etiology

Paul¹,

Marlin

Parodi³

et al. 2017

Audiol Neurotol

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Objective: Unilateral sensorineural hearing loss (USNHL) is known to impact on school performance and social skills during childhood, but the etiologies remain unclear. The aim of this study was to assess various etiologies and to study the clinical contexts in this population. Methods: The study is a retrospective review. Characteristics of hearing loss (HL), audiometric parameters, imaging, and genetic and medical contexts were analyzed. Results: Eighty children were included. USNHL was profound in 68%, could be progressive in 19%, and become bilateral in 7.5% of cases. Inner ear malformations were identified in 41% of cases; cochlear nerve deficiency (CND) was frequent (33%). Cytomegalovirus (CMV) infection and genetic syndromes were confirmed in 10 and 6% of cases, respectively. Conclusion: Long-term hearing follow-up remains useful in USNHL as it can become bilateral. Looking to etiology, MRI should be the gold standard, as CND is frequently observed and screening for CMV infection should be systematic. Genetic etiologies appear to be different compared to bilateral HL. Further genetic research in this domain is needed.

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Section: Discussionmentioning

confidence: 73%

Unilateral Sensorineural Hearing Loss: Medical Context and Etiology

Paul¹,

Marlin

Parodi³

et al. 2017

Audiol Neurotol

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“…Milewska-Bobula et al 29 indicated increased emotional sensitivity and problems with school maturity in 6-year-old children with asymptomatic or mildly symptomatic cCMV infection, and Karltorp et al 30 showed that 88% of 26 children with congenital CMV infection had balance disturbances including walking at a later age. Whether WMAs in cCMV infection cause a subsequent developmental disorder is still unclear,14 25 26 and newborns and infants with SNHL in our study showed far more abnormal CNS findings other than WMAs than those without SNHL; thus SNHL could occur in children with more severely damaged CNS.…”

Section: Discussionmentioning

confidence: 99%

Screening for seemingly healthy newborns with congenital cytomegalovirus infection by quantitative real-time polymerase chain reaction using newborn urine: an observational study

et al. 2017

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ObjectiveApproximately 8–10% of newborns with asymptomatic congenital cytomegalovirus (cCMV) infection develop sensorineural hearing loss (SNHL). However, the relationship between CMV load, SNHL and central nervous system (CNS) damage in cCMV infection remains unclear. This study aimed to examine the relationship between urinary CMV load, SNHL and CNS damage in newborns with cCMV infection.Study designThe study included 23 368 newborns from two maternity hospitals in Saitama Prefecture, Japan. Urine screening for cCMV infection (quantitative real-time PCR) and newborn hearing screening (automated auditory brainstem response (AABR) testing) were conducted within 5 days of birth to examine the incidence of cCMV infection and SNHL, respectively. CNS damage was assessed by MRI of cCMV-infected newborns.ResultsThe incidence of cCMV infection was 60/23 368 (0.257%; 95% CI 0.192% to 0.322%). The geometric mean urinary CMV DNA copy number in newborns with cCMV was 1.79×106 copies/mL (95% CI 7.97×105 to 4.02×106). AABR testing revealed abnormalities in 171 of the 22 229 (0.769%) newborns whose parents approved hearing screening. Of these 171 newborns, 22 had SNHL (12.9%), and 5 of these 22 were infected with cCMV (22.7%). Newborns with both cCMV and SNHL had a higher urinary CMV DNA copy number than newborns with cCMV without SNHL (p=0.036). MRI revealed CNS damage, including white matter abnormalities, in 83.0% of newborns with cCMV. Moreover, newborns with CNS damage had a significantly greater urinary CMV load than newborns without CNS damage (p=0.013).ConclusionsWe determined the incidence of cCMV infection and urinary CMV DNA copy number in seemingly healthy newborns from two hospitals in Saitama Prefecture. SNHL and CNS damage were associated with urinary CMV DNA copy number. Quantification of urinary CMV load may effectively predict the incidence of late-onset SNHL and neurodevelopmental disorders.

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“…The critical appraisal of the 30 studies is presented in Table . One study was a prospective cohort study, all other studies were retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

“…One study was a prospective cohort study, all other studies were retrospective studies. Twenty‐three studies included children with cCMV‐related hearing loss as well as children with other causes of hearing loss . Eleven studies directly compared a cCMV‐group to a non‐cCMV‐group .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐three studies included children with cCMV‐related hearing loss as well as children with other causes of hearing loss . Eleven studies directly compared a cCMV‐group to a non‐cCMV‐group . The non‐cCMV group included children with various causes of SNHL in five studies, and children with hereditary SNHL due to connexine 26 (Cx26) mutation in six studies .…”

Section: Resultsmentioning

confidence: 99%

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