The Association Between Congenital Cytomegalovirus Infection and Cerebral Palsy: A Systematic Review and Meta-Analysis

Abstract

Background Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 0.6% of all livebirths. Symptomatic and asymptomatic congenital CMV infections are frequently associated withneurodevelopment impairment, motor, and cognitive deficits. Intrauterine infection such as CMVinfection is a risk factor for developing cerebral palsy, which is one of the most common physicaldisability in children. This study aims to investigate the association between congenital CMV infectionand the development of cerebral palsy. Methods A systematic literature search was conducted in EMBASE, MEDINE, and Google Scholar from January2000 to December 2020 to identify relevant studies. The quality of studies was assessed using theNewcastle-Ottawa-Scale. The random-effect model was used to calculate the pooled prevalence.Statistical analysis was conducted using the generic reverse variance method in Cochrane ReviewManager v5.4. Results A total of 12 studies involving 3665 patients were included in this systematic review and meta-analysis.The overall pooled prevalence (random effect) of cerebral palsy among patients diagnosed withcongenital CMV infection was 25.0% (95% CI, 0.12-0.38). The overall pooled prevalence (random effect)of congenital CMV infection among patients with cerebral palsy was 10.0% (95% CI, 0.04-0.15). Themost common type of cerebral palsy caused by CMV infection in children was spastic, followed byataxic, dyskinetic, and hypotonic. Conclusions CMV infection is significantly associated with the development of cerebral palsy in children. Earlyneonatal and pregnancy screening of CMV is essential to improve the outcome of CMV infection.Moreover, children diagnosed with CMV infection require regular clinical follow-up and comprehensiveneurological examination for early detection of cerebral palsy.