Congenital Cytomegalovirus among Children with Cerebral Palsy

Hayley Smithers-Sheedy; Camille Raynes-Greenow; Nadia Badawi; Marian A Fernandez; Alison Kesson; Sarah McIntyre; Kin-Chuen Leung; Cheryl A Jones

doi:10.1016/j.jpeds.2016.10.024

Congenital Cytomegalovirus among Children with Cerebral Palsy

J Pediatr. 2017 Feb:181:267-271.e1. doi: 10.1016/j.jpeds.2016.10.024. Epub 2016 Nov 3.

Authors

Hayley Smithers-Sheedy¹, Camille Raynes-Greenow², Nadia Badawi³, Marian A Fernandez⁴, Alison Kesson⁴, Sarah McIntyre⁵, Kin-Chuen Leung⁶, Cheryl A Jones⁷

Affiliations

¹ Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia.
² School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
³ The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia.
⁴ Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
⁵ Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
⁶ The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
⁷ Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia. Electronic address: cheryl.jones@health.nsw.gov.au.

PMID: 27816221
DOI: 10.1016/j.jpeds.2016.10.024

Abstract

Objectives: To determine the proportion of children with cerebral palsy (CP) and cytomegalovirus (CMV) DNA detected retrospectively in their newborn screening cards (NBSC), to compare the proportion of children with CMV DNA in their NBSC across spastic subtypes of CP, and to compare the sex and other characteristics of children with CP and CMV detected on their NSBC with those in whom CMV DNA was not detected.

Study design: Retrospective observational study. Data were extracted from patient records on children with CP (birth years 1996-2014) from 2 Australian state CP registers and state-wide paediatric rehabilitation services with consent. NBSCs were retrospectively analyzed for CMV DNA by nested polymerase chain reaction (PCR) using primers against gB. Positive samples were validated using real time PCR for CMV UL83.

Results: Of 401 children recruited, 323 (80.5%) had an available NBSC. Of these, 31 (9.6%; 95% CI, 6.8-13.3) tested positive for CMV DNA by nested PCR for CMV gB, of whom 28 (8.7%; 95% CI, 6.1-12.2) also had CMV DNA detected by real-time PCR for CMV UL83. Detection of CMV DNA was significantly associated with epilepsy, but not with clinical or epidemiologic characteristics, including sex and pattern of spasticity.

Conclusions: CMV viremia in the newborn period, indicating congenital CMV infection, is highly prevalent among children with CP. Further research is needed to investigate the mechanisms and contribution of congenital CMV to the causal pathways to CP.

Keywords: development; disability; neurotropic; newborn screening; registry; virus.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Australia
Cerebral Palsy / complications*
Cerebral Palsy / virology
Cytomegalovirus / genetics*
Cytomegalovirus Infections / complications
Cytomegalovirus Infections / congenital
Cytomegalovirus Infections / epidemiology*
DNA, Viral / analysis
Female
Humans
Infant, Newborn
Male
Neonatal Screening / methods
Polymerase Chain Reaction
Registries
Retrospective Studies

Substances

DNA, Viral