RT Journal Article
SR Electronic
T1 Vestibular and balance dysfunction in children with congenital CMV: a systematic review
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP fetalneonatal-2021-323380
DO 10.1136/archdischild-2021-323380
A1 Annalie Shears
A1 Georgina Yan
A1 Harriet Mortimer
A1 Elizabeth Cross
A1 Shari Sapuan
A1 Seilesh Kadambari
A1 Suzanne Luck
A1 Paul T Heath
A1 Simone Walter
A1 Katy J Fidler
YR 2022
UL http://fn.bmj.com/content/early/2022/05/11/archdischild-2021-323380.abstract
AB Objective This systematic review evaluates vestibular and balance dysfunction in children with congenital cytomegalovirus (cCMV), makes recommendations for clinical practice and informs future research priorities.Design MEDLINE, Embase, EMCARE, BMJ Best Practice, Cochrane Library, DynaMed Plus and UpToDate were searched from inception to 20 March 2021 and graded according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.Patients Children with cCMV diagnosed within 3 weeks of life from either blood, saliva and/or urine (using either PCR or culture).Intervention Studies of vestibular function and/or balance assessments.Main outcome measures Vestibular function and balance.Results 1371 studies were identified, and subsequently 16 observational studies were eligible for analysis, leading to an overall cohort of 600 children with cCMV. All studies were of low/moderate quality. In 12/16 studies, vestibular function tests were performed. 10/12 reported vestibular dysfunction in ≥40% of children with cCMV. Three studies compared outcomes for children with symptomatic or asymptomatic cCMV at birth; vestibular dysfunction was more frequently reported in children with symptomatic (22%–60%), than asymptomatic cCMV (0%–12.5%). Two studies found that vestibular function deteriorated over time: one in children (mean age 7.2 months) over 10 months and the other (mean age 34.7 months) over 26 months.Conclusions Vestibular dysfunction is found in children with symptomatic and asymptomatic cCMV and in those with and without hearing loss. Audiovestibular assessments should be performed as part of neurodevelopmental follow-up in children with cCMV. Case–controlled longitudinal studies are required to more precisely characterise vestibular dysfunction and help determine the efficacy of early supportive interventions.PROSPERO registration CRD42019131656.Data are available on reasonable request.