Source:

Lopez
AS
,
Lanzieri
TM
,
Claussen
AH
, et al
.
Intelligence and academic achievement with asymptomatic congenital cytomegalovirus infection
.
Pediatrics
.
2017
Nov
;
140
(
5
).
e20171517
. doi:
https://doi.org/10.1542/peds.2017-1517

Investigators from the CDC and Texas Children’s Hospital, Houston, TX, conducted a longitudinal case control study to assess intelligence and academic achievement in children with asymptomatic cytomegalovirus (CMV) infections. Cases were children born between 1982 and 1992 at Women’s Hospital of Texas who were found to be positive on newborn screening for CMV (based on a urine culture within the first 3 weeks of life). Only newborns with no signs of congenital CMV disease (ie, no purpura, petechiae, jaundice, hepatosplenomegaly, microcephaly, elevated liver enzymes, hemolytic anemia, or thrombocytopenia) were included as cases. Controls were children who screened negative for CMV at birth and matched with a case on date of birth (within 6 days). Study participants were assessed with standardized, age-appropriate, full-scale intelligence, receptive and expressive language, and academic achievement tests at multiple periods during their childhood, including infancy, preschool, elementary school, middle school, and high school. All study children had audiological testing to detect sensorineural hearing loss (SNHL) before the age of 2 years. The investigators used “growth curve” modeling to account for trends in scores over time and to adjust for potentially confounding variables such as maternal education levels. Comparisons were made between cases with normal hearing and controls and between cases with SNHL and control children.

During the study period, 32,543 newborns were screened for CMV; 135 (0.4%) tested positive. Study data were collected on 78 cases with normal hearing, 11 cases with SNHL, and 40 controls (no control child was diagnosed with SNHL before the age of 2 years). Mean (95% CI) full-scale intelligence test scores at 5 and 18 years of age, respectively, were 108 (105, 110) and 111 (108, 114) for cases with normal hearing, 101 (95, 106) and 104 (98, 110) for cases with SNHL, and 108 (104, 111) and 111 (107, 114) for controls. Overall, there were no significant differences between cases with normal hearing and controls (P=.96), but cases with SNHL had scores that were 7 points lower than controls (P<.05). There were no significant differences between cases with normal hearing and controls for expressive and receptive language scores (P=.36); cases with SNHL had significantly lower receptive, but not expressive, language scores than controls. Math and reading scores were not significantly different across all 3 groups.

The authors conclude that infants with asymptomatic CMV infection with normal hearing by age 2 years do not appear to have differences in intelligence, language development, or academic achievement during childhood compared with uninfected children.

Dr Brady has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Testing for congenital CMV infection is not part of routine newborn screening in the United States. However, Utah2...

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