Association between Congenital Cytomegalovirus Infection and Brain Injury in Neonates: A Meta-analysis of Cohort Studies.

Li Zhang,Xiang Han,Wenfeng Wang,Zhankui Li,Yingli Cao,Hongyan Du,Yingmei Liu,Horacio Soto

doi:10.1155/2021/9603660

Abstract

Objective To assess association between congenital cytomegalovirus (CMV) infection and brain injury in neonates. Methods The literatures from inception to November 4, 2020, were searched through PubMed, Embase, Cochrane Library, and Web of Science. Heterogeneity test was conducted for each indicator and measured by I2 statistics. If I2 ≥ 50%, the random effects model was applied; otherwise, the fixed effects model was used. Sensitivity analysis was performed for all models. Weighed mean difference (WMD) was used as the effect size for measurement data, and risk ratio (RR) was as the effect indicator. Results A total of 13 studies, including 4,262 congenital CMV infection neonates, were enrolled in this study. Our results showed that the rate of hearing impairment (RR: 2.105, 95% CI: (1.115, 3.971), P = 0.002), sensorineural hearing loss (SNHL) (RR: 17.051, 95% CI: (6.201, 46.886), P < 0.001), and microcephaly (RR: 2.283, 95% CI: (1.325, 3.935), P =0.003) in neonates infected congenital CMV was higher than that in control group. Conclusion The risks of hearing impairment, SNHL, and microcephaly in neonates during childhood may be associated with congenital CMV infection. It is necessary to establish neonatal screening programs and comprehensive diagnostic tests for patients to reduce the risk of adverse brain damage to the congenital CMV infection as early as possible and to improve the prognosis of the newborn.

Highlights

Congenital cytomegalovirus (CMV) infection refers to an infectious disease caused by vertical transmission of CMV in the fetus due to the mother’s CMV infection during pregnancy, which causes damage to multiple organs of the fetus or newborn [1, 2]
The results showed that the rate of hearing impairment in CMV group was significantly higher than that in control group (RR: 2.105, 95% CI: (1.115, 3.971), P = 0:002) (Figure 2 and Table 2)
The results revealed that there was no significant difference in neurodevelopmental delay between the infection group and the control group (I2 = 54:0%, risk ratio (RR): 2.910, 95% CI: (0.417, 20.285), P = 0:281) (Figure 5 and Table 2)

Summary

Introduction

Congenital cytomegalovirus (CMV) infection refers to an infectious disease caused by vertical transmission of CMV in the fetus due to the mother’s CMV infection during pregnancy, which causes damage to multiple organs of the fetus or newborn [1, 2]. After pregnant women are infected with CMV, the vertical transmission rate is as high as 32%-40%, with the prevalence of congenital CMV infection worldwide in live born newborns is 0.5%-3% [2]. CMV in pregnant congenital CMV infection women causes intrauterine infection of the fetus through the placenta, which is the most important cause of congenital central nervous system damage caused by intrauterine infection. CMV infected infants may have severe brain damage, causing brain dysfunction, such as severe decreases in cognitive capacity, mental retardation, and seizures [3,4,5]. Several studies showed congenital CMV infection patients develop long-term sequelae, including sensorineural hearing loss (SNHL) and neurodevelopmental damage, ranging up to severe decreases in cognitive capacity, which

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Discussion

Conclusion