G114(P) Chromosome and urine cytomegalovirus testing in symmetrically growth retarded infants

Abstract

Aims Chromosome analysis and cytomegalovirus (CMV) infection screening are commonly being done to investigate the underlying cause for symmetrical intra uterine growth restriction (IUGR). However, recent papers express the concern of low yield and associated high cost. Microarray testing has a high rate of incidental findings seen in the general population which may create unnecessary anxiety among the parents. Our objective is to evaluate the significance of chromosomal disorders and urine CMV in symmetrically IUGR babies. Methodology This was a retrospective cohort study of IUGR babies over a six-year (2011–2017) period in a tertiary neonatal unit. We collected details of IUGR babies by using neonatal database and case notes. Genetic results were obtained from regional genetic database and CMV results from electronic reporting system. Results Results are shown in the table 1: With abnormal array results, the incidences of incidental findings are 8% for non-IUGR referrals and 68% for IUGR referrals. For non-IUGR referrals 52% appear to explain the referral and in IUGR referrals only 10% appear to explain the referral. The chance of significant results are higher with non-IUGR referrals than IUGR referrals, so the yield for meaningful chromosome testing. 118 babies had urine CMV testing and 1 had positive result. However, this baby was investigated for clinical presentation of congenital CMV- hepatosplenomegaly and petechial rash. Conclusions We found that the majority of the findings identified in isolated symmetrical IUGR babies are incidental and do not explain the IUGR. Urine CMV testing should be considered in IUGR babies only if there are clinical features suggestive of intra-uterine infection and chromosome testing only if there are associated phenotypic features or positive family history.