Original ArticleClinical, Biochemical, and Neuroimaging Findings Predict Long-Term Neurodevelopmental Outcome in Symptomatic Congenital Cytomegalovirus Infection
Section snippets
Methods
The study cohort comprised all newborns with a symptomatic congenital CMV infection who were admitted to La Paz Hospital, a university tertiary hospital located in Madrid, Spain, between 1993 and 2009, including the patients in our previous cohort.21 Patients with a major malformation, genetic or chromosomal syndrome, other congenital infection, or a CNS-significant disease not related to CMV were excluded. Patients born between 1993 and 2000 were identified retrospectively by reviewing the
Results
A total of 29 infants with symptomatic congenital CMV infection were identified, 3 of whom were excluded from our analysis (2 with a major malformation and 1 with a chromosomal syndrome). Of the remaining 26 patients, 15 were born after 2000 and were included prospectively. Important demographic, perinatal, and clinical characteristics of the study patients are presented in Table I. Seventeen patients (65%) received ganciclovir therapy, including 15 of 20 patients with CNS involvement33, 34
Discussion
Our results demonstrate that relative microcephaly, elevated CSF protein and β2-m levels, and moderate-severe neuroimaging abnormalities are neonatal predictors of adverse neurologic and developmental outcomes for symptomatic congenital CMV infection. The presence of high CSF β2-m concentrations at birth appears to be the best independent biomarker of moderate-severe adverse prognosis. Moreover, analysis of both CSF β2-m and HC or especially neuroimaging findings provides better predictive
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Partially supported by Roche Spain, which was not involved in the study design; the collection, analysis and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.