588: Maternal primary cytomegalovirus infection: is there an association with small for gestational age neonates?

Abstract

an association with small for gestational age neonates? Giuliana Simonazzi, Alessandra Curti, Brunella Guerra, Margherita Contoli, Paola Murano, Chiara Puccetti, Antonio Farina, Nicola Rizzo Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital, Bologna, Italy, Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital, Bologna, Italy, bologna, Italy OBJECTIVE: to evaluate the rate of small for gestational age (SGA) neonates in primary cytomegalovirus (CMV) infection and the performance of prenatal ultrasound in prediction of SGA. STUDY DESIGN: Retrospective study including primary CMV infections referred to our Hospital between 2007 and 2011. Neonates were classified as uninfected, infected asymptomatic and symptomatic. Abdominal circumference (AC) and estimated fetal weight (EFW) were used to build up a ROC curve for evaluating the detection rate (DR) of ultrasound in prediction of infected SGA neonates. RESULTS: Follow-up was available in 209 cases. Sixty-two neonates (29%) resulted infected at birth; 14 were symptomatic (22%); congenital neurosensory hearing loss was diagnosed in all cases, one of them presented also a brain anomaly. The overall SGA rate was 10% and the distribution did not differ in the groups (8% vs 12% vs 21%, respectively). Prenatal ultrasound data were available in 130 cases. Uterine artery Doppler was altered in 2 cases (15%), both within uninfected group. According to prediction of SGA in maternal infection, a cut off of 10th centile of EFW achieved a DR of 25% (FPR of 6%). Within infected neonates, instead, a DR of 25% and 50% was achieved by AC and EFW, respectively (at FPR of 10%) and correspondent cut-off value were 22th and 10th centile. CONCLUSION: congenital CMV infection does not seem to be associated with increased rate of SGA neonates. Ultrasound not identify properly SGA neonates in case of both primary maternal infection or congenital infection. Neurosensory hearing loss is very frequent in infected SGA neonates.