Children with congenital cytomegalovirus (cCMV) infection are about 2.5 times more likely to be diagnosed with autism spectrum disorder (ASD) than their peers, according to a new study.
“Clinicians may want to be proactive in monitoring for early signs of ASD in children with a diagnosis of cCMV, especially those with hearing loss, the risk of which is elevated among both children with cCMV and those with ASD,” authors wrote in “Autism Spectrum Disorder Diagnoses and Congenital Cytomegalovirus” (Pesch MH, et al. Pediatrics. May 29, 2024).
Previous studies have linked cCMV, the most common congenital infection in the U.S., to central nervous system anomalies. Researchers from the University of Michigan and Centers for Disease Control and Prevention set out to look more closely at possible ties to autism. They analyzed data on nearly 3 million children enrolled in Medicaid or the Children’s Health Insurance Program from birth through 4-6 years.
Nearly half of those with cCMV had a central nervous system anomaly or injury, according to the study. About 64 of every 1,000 children with cCMV was diagnosed with autism compared to 25 of every 1,000 children without cCMV.
Researchers’ adjusted calculations determined children with cCMV were 2.5 times more likely to be diagnosed with autism. Females with cCMV had 4.65 times the risk of autism and males had nearly 2 times the risk compared to their peers without cCMV.
“Maternal CMV infection can activate an inflammatory state which may, in turn, impact fetal brain development, thereby increasing the risk of ASD,” authors wrote.
They noted brain anomalies accounted for some of the risk, but they also saw links between cCMV and autism in children without brain anomalies, preterm birth or low birth weight.
The links they found between the infection and autism could have been influenced in part by children with cCMV being monitored closely for neurodevelopmental issues. The data could not address whether other pregnancy factors played a role in their findings or whether they apply to children with asymptomatic cCMV infection.
To better understand the results, authors called for more study of children with cCMV identified through universal screening programs and followed long term.
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