Polish Newborns Research Articles

Reference Values for Birth Weight in Relation to Gestational Age in Poland and Comparison with the Global Percentile Standards.

Percentiles of birth weight by gestational age (GA) are an essential tool for clinical assessment and initiating interventions to reduce health risks. Unfortunately, Poland lacks a reference chart for assessing newborn growth based on the national population. This study aimed to establish a national reference range for birth weight percentiles among newborns from singleton deliveries in Poland. Additionally, we sought to compare these percentile charts with the currently used international standards, INTERGROWTH-21 and WHO. All singleton live births (n = 3,745,239) reported in Poland between 2010 and 2019 were analyzed. Using the Lambda Mu Sigma (LMS) method, the Generalized Additive Models for Location Scale, and Shape (GAMLSS) package, smoothed percentile charts (3-97) covering GA from 23 to 42 weeks were constructed. The mean birth weight of boys was 3453 ± 540 g, and this was higher compared with that of girls (3317 ± 509 g). At each gestational age, boys exhibited higher birth weights than girls. The weight range between the 10th and 90th percentiles was 1061 g for boys and 1016 g for girls. Notably, the birth weight of Polish newborns was higher compared to previously published international growth standards. The reference values for birth weight percentiles established in this study for Polish newborns differ from the global standards and are therefore useful for evaluating the growth of newborns within the national population. These findings hold clinical importance in identifying neonates requiring postbirth monitoring.

Comparison of application of Fenton, Intergrowth-21st and WHO growth charts in a population of Polish newborns

Background: Growth charts are the primary tools for evaluating neonatal birth weight and length. They help and qualify the neonates as Appropriate for Gestational Age (AGA), Small for Gestational Age (SGA), or Large for Gestational Age (LGA). The most commonly used neonatal charts include Intergrowth-21st, WHO, and Fenton. The aim of the study was to compare the tools used for assessing neonatal birth weight and the incidence of SGA and LGA using the different charts. Methods: Data on 8608 births in the Clinical Department of Obstetrics and Gynecology were compared. We divided the patient population into five gestational age groups. The 10th and 90th percentiles were calculated. The percentage of cases meeting the SGA and LGA criteria was determined. Results: Statistically significant differences between growth charts were identified for each of the groups. The 10th percentile for the study population corresponded to 2970 g for females and 3060 g for males born in the 40th week of gestation. The 90th percentile values were 4030 g and 4120 g. Our analysis showed a statistically significant difference in detection of LGA or SGA between three growth charts and our data both in male (χ2(3) = 157.192, p < 0.001, Kramer’s V = 0.444) and female newborns (χ2(3) = 162.660, p < 0.001, Kramer’s V = 0.464). Discussion: Our results confirm that differences exist between growth charts. There is a need for harmonizing growth assessment standards. It is recommended that a growth chart should be developed for the Polish population, which would improve the diagnosis of SGA and LGA.

Comparative study of cord blood lipid profile in preterm and post term neonates

Background: The fetal-origin hypothesis and fetal programming emphasize the profound and sustained impact of factors related to fetal health on the development of chronic disease in adulthood. Several studies suggested that low birth weight and preterm birth linked to abnormalities in cord lipid profile and higher prevalence of atherosclerotic cardiovascular disease. Authors objectives was to estimate and compare cord lipid profile in term, pre-term, and post-term neonates.Methods: In the study group, there were 200 healthy Polish newborns. Newborn characteristics included sex, gestational age at birth, Apgar score, and anthropometric data (weight and length at birth, neonatal ponderal index, head, chest and abdominal circumferences, placental weight, and placental-fetal weight ratio). Cord blood samples were collected for total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Information regarding selected maternal factors was collected. Neonates were classified into preterm (<37 weeks) and term (≥37 weeks) based on new Ballard scoring.Results: The preterm had higher Total cholesterol compared to Term and post term and it was Statistically Significant with a p value of < 0.001. The preterm had higher Triglycerides compared to term and post term and it was statistically significant with a p value of <0.01. The preterm had higher HDL compared to Term and post term and it was statistically significant with a p value of <0.001. The preterm had higher LDL compared to Term and post term it was statistically significant with a p value of <0.001. The preterm had higher VLDL compared to Term and post term and it was statistically significant with a p value of <0.01.Conclusions: Abnormal intrauterine milieu created by maternal changes during gestation may bear a profound impact on lipid metabolism in neonates, which may account for their differences in lipid profile and anthropometry at birth.

Non-replication of an association between theOdd-skipped related 1c.654G>A (rs12329305) polymorphism and kidney volume in newborns

AbstractIntroduction: Odd-skipped related 1 (Osr1) protein is a marker of intermediate mesoderm from which all definitive kidney progenitor cells develop. The loss-of-functionOSR1c.654G>A (rs12329305) polymorphism has been associated with a reduced kidney volume at birth and congenital renal anomalies.The aim of this study was to re-investigate whether theOSR1c.654A allele is associated with a smaller kidney volume (a surrogate of the congenital nephron number) in newborns, either alone or in combination withRETc.1296G>A(RETxOSR1interaction).Materials and methods: A total of 178 healthy, full-term Polish newborns were included in this study. Kidney size was measured by ultrasound on the third day of life and normalised for body surface area (TKV/BSA). TheOSR1polymorphism was identified by mini-sequencing. The reduced model without interaction and the full model including interaction terms were compared using the F test.Results: TKV/BSA did not differ across the genotype groups, t(176) = −0.45, p = 0.653 (106 ±24 and 108 ±25 mL/m2 for GG and GA, respectively). Similarly, there was no effect of the c.654G>A geno-type on TKV/BSA after controlling for the effect of covariates, F(1,175) = 0.28, p = 0.598. There was no association of theRETxOSR1interaction on the TKV/BSA.Conclusion: We did not find an association between theOSR1c.1296G> A polymorphism, alone and in combination withRETc.645G> A and kidney size in a group of healthy full-term newborns.

Classic Congenital Adrenal Hyperplasia Due to 21-hydroxylase Deficiency - The Next Disease Included in the Neonatal Screening Program in Poland

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. The most common form of CAH is caused by mutations in CYP21A, the gene encoding the adrenal steroid 21-hydroxylase enzyme. Deficiency of the enzyme leads to life-threatening adrenocortical insufficiency, which is not demonstrable during the first days of life. Additionally, some of the affected neonates have varying degrees of pathology of the external genitalia, classified as disorders of sex development (DSD). These make it difficult to recognize the sex of the affected neonate or lead to incorrect sex assignment.CAH has been included in neonatal screening programs in many countries of the world since the late of 1970s. The main benefit of the screening is early diagnosis and prevention of neonatal mortality in children with salt-wasting CAH. Early recognition of the disease is also helpful in correct sex assignment of DSD neonates.In 2016 Poland joined the group of countries which conduct neonatal screening for 21-hydroxylase deficient CAH and the condition is now included in the neonatal screening program. Therefore, it is possible to recognize the disease soon after birth in all Polish newborns and to start the prompt replacement steroid therapy. As the information on the suspicion or diagnosis of CAH in very young newborns has recently reached neonatologists, pediatricians, and general practitioners, and not only pediatric endocrinologists, the aim of this paper is to deliver the most necessary information on the disease to a wider group of doctors, not familiar with CAH.

Cord blood lipid profile in healthy newborns: A prospective single-center study.

Atherosclerosis may originate during the fetal period, therefore it is reasonable to identify early risk markers of lifestyle diseases. The aim of the study was to determine the relationship between fetal and maternal factors, and the neonatal cord blood lipid profile in term newborns. In the study group, there were 206 healthy Polish newborns. Newborn characteristics included sex, gestational age at birth, Apgar score, and anthropometric data (weight and length at birth, neonatal ponderal index, head, chest and abdominal circumferences, placenta weight, and placental-fetal weight ratio). Cord blood samples were collected for total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Information regarding selected maternal factors was collected. The cord blood concentration of TC (p = 0.0007), HDL (p = 0.001) and LDL (p = 0.003) was higher in girls than in boys. A significant positive correlation was found between TG and gestational age (p < 0.0001; r = 0.29). Significant negative correlations between maternal preconception BMI and TC (p = 0.03; r = -0.14), HDL (p = 0.04; r = -0.13) and LDL (p = 0.02; r = -0.15) were observed. In our study group, the influence of the newborns' gender, gestational age and mothers' preconception BMI on lipid concentration was observed. Further investigations are needed to determine markers in cord blood that may predict future metabolic disorders.

Sonographic Reference Ranges for the Thyroid Gland in Euthyroid Term Newborns.

This study aims to establish the reference ranges for normal thyroid gland (length, width, depth, and volume) in healthy term Polish neonates within the first week of life to aid in the comparative evaluation of infants with suspected thyroid disease. A total of 148 term neonates from mothers with normal thyroid function were examined during their first week of life. Ultrasound examination was performed in both longitudinal and transverse projections to create reference value percentile charts for thyroid volume in healthy term neonates. Median (range) width, depth, and length were 0.714 (range, 0.470-0.959), 0.677 (range, 0.527-0.960), 2.07 (range, 1.540-2.870) cm for the right lobe of the thyroid: and 0.720 (range, 0.535-1.010), 0.678 (range, 0.521-0.952), 2.015 (range, 1.620-2.730) cm for the left. Volumes for right lobe, left lobe, and both lobes combined were 0.502 (range, 0.228-0.931), 0.511 (range, 0.294-0.959), and 1.014 (range, 0.526-1.849) mL. Diagnostic ultrasound examination of the thyroid in the neonate is a simple and useful method for assessment of thyroid gland disease and neonatal health. This study provides robust normative data for Polish newborns. Furthermore, we have found different values compared with other countries, particularly Scotland, which underlines the importance of establishing population-based data.

High-Resolution Array Comparative Genomic Hybridization Utility in Polish Newborns with Isolated Cleft Lip and Palate

Cleft lip with or without cleft palate is one of the most common birth defects of unknown etiology. A fraction of its genetic causes is attributable to copy number variations detected by array comparative genomic hybridization. The value of array comparative genomic hybridization screening as a first-tier test in the newborn population with multiple congenital anomalies has now been accepted. Due to unspecific clinical picture at this age, it can also be applied to neonates with isolated anomalies. Our purpose was to assess utility of array comparative genomic hybridization in the population of newborns with isolated cleft lip and palate. We conducted the study in a group of 52 Polish newborns with apparently isolated cleft lip and palate. In the study group, we found 8 rearrangements. Of these, 2 de novo events have been noted that potentially explain the phenotype. In addition, 2 novel candidate genes for cleft lip and palate, CHN2 and CDH19, are suggested. Given the high number of inherited potentially benign changes, we question the clinical utility of array comparative genomic hybridization in the newborn population with isolated cleft lip and palate, at the same time pointing to the need of skilled professional's clinical assessment at a later age. However, the value of this technology in searching for the cause of isolated anomalies cannot be underestimated.

The development of guidelines for management of thyroid diseases in pregnancy – current status

The development of guidelines for management of thyroid diseases in pregnancy – current status

The role of genetic variability in the 5′ untranslated region of RAD51 in Polish newborns with HCMV infection

Human cytomegalovirus (HCMV) can inflict site-specific chromosomal damage in form of double-strand breaks (DSBs). Many of studies have analyzed cell repair capabilities, following viral infection. The cellular reaction to DNA damaging agents can modulate the susceptibility to viral infection. This reaction is mainly determined by DNA repair efficacy which, in turn, may be influenced by the variability of DNA repair genes, expressed by their polymorphisms. This report describes studies of the distribution of genotypes and the frequency of alleles of the G135C (rs1801320) and G172T (rs1801321) RAD51 polymorphism in 15 paraffin-embedded samples of brain, kidney and liver tissue from HCMV infected infants. RAD51 polymorphisms were determined by PCR-RFLP. The distribution of genotypes for G135C and G172T polymorphism in the samples was as follows: 3 (20%) for 135G/G, 12 (80%) for 135G/C genotype and 12 (80%) for 172G/G and 3 (20%) for 172G/T genotype, respectively. Neither 135C/C nor 172T/T homozygous variant was detected. No differences were revealed among liver, kidney and brain samples, either in genotype distribution or allele frequency. HCMV infected patients had an overrepresentation of 135G and 172G alleles. This is the first study, linking single nucleotide polymorphisms of RAD51 gene with the incidence of HCMV infection in the population of Polish infants. The results support the hypothesis that RAD51 polymorphisms may be associated with viral infection.

Effect of vitamin D status on pharmacological treatment efficiency

At least 80% of the whole Polish population, including prepubertal children and adolescents, adults and seniors, are vitamin D deficient, defined as 25(OH)D < 50 nmol/L. 83% of Polish newborns start their lives at the state of vitamin D deficiency because 78% of their mothers are also deficient. It was observed that treating patient vitamin D deficiency to vitamin D status serum 25(OH)D) 75–100 nmol/L increased effectiveness of therapies in infectious diseases (chronic hepatitis C, tuberculosis), osteoporosis, multiple sclerosis, epilepsy, Chronic Kidney Diseases and atopic dermatitis. . For these reasons doctors should take special attention to vitamin D status in patients suffering for these diseases properly implementing recent vitamin D recommendation.

Association of functional genetic variants of A-kinase anchoring protein 10 with QT interval length in full-term Polish newborns.

IntroductionA-Kinase Anchoring Proteins (AKAPs) coordinate the specificity of protein kinase A signaling by localizing the kinase to subcellular sites. The 1936G (V646) AKAP10 allele has been associated in adults with low cholinergic/vagus nerve sensitivity, shortened PR intervals in ECG recording and in newborns with increased blood pressure and higher cholesterol cord blood concentration. The aim of the study was to answer the question of whether 1936A > G AKAP10 polymorphism is associated with the newborn electrocardiographic variables.Material and methodsElectrocardiograms were recorded from 114 consecutive healthy Polish newborns (55 females, 59 males), born after 37 gestational weeks to healthy women with uncomplicated pregnancies. All recordings were made between 3rd and 7th day of life to avoid QT variability. The heart rate per minute and duration of PR, QRS, RR and QT intervals were usually measured. The ECGs were evaluated independently by three observers. At birth, cord blood of neonates was obtained for isolation of genomic DNA.ResultsThe distribution of anthropometric and electrocardiographic variables in our cohort approached normality (skewness < 2 for all variables). No significant differences in anthropometric variables and electrocardiographic traits with respect to AKAP10 genotype were found. Multiple regression analysis with adjustment for gender, gestational age and birth mass revealed that QTc interval in GG AKAP10 homozygotes was significantly longer, but in range, when compared with A alleles carriers (AA + AG, recessive mode of inheritance). No rhythm disturbances were observed.ConclusionsResults demonstrate possible association between AKAP10 1936A > G variant and QTc interval in Polish newborns.

Association of Genetic Variation in Calmodulin and Left Ventricular Mass in Full-Term Newborns

Calmodulin II (CALM2) gene polymorphism might be responsible for the variation in the left ventricular mass amongst healthy individuals. The aim was to evaluate the correlation between left ventricular mass (LVM) and g.474955027G>A (rs7565161) polymorphism adjacent to the CALM2 gene. Healthy Polish newborns (n = 206) were recruited. Two-dimensional M-mode echocardiography was used to assess LVM. Polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism and sequencing analyses. The carriers of the G allele of the CALM2 polymorphism had significantly higher left ventricular mass/weight (LVM/BW) values, when compared with newborns homozygous for the A allele (3.1 g/m2 versus 2.5 g/m2, P adjusted = 0.036). The AG genotype of CALM2 was associated with the highest values of LVM/BW, exhibiting a pattern of overdominance (2.9 g/kg versus 3.1 g/kg versus 2.5 g/kg, P adjusted = 0.037). The results of this study suggest that G>A CALM2 polymorphism may account for subtle variation in LVM at birth.

Effect of vitamin D status on pharmacological treatment efficiency: Impact on cost-effective management in medicine.

At least 80% of the whole Polish population, including prepubertal children and adolescents, adults and seniors, are vitamin D deficient, defined as 25(OH)D < 50 nmol/L. 83% of Polish newborns start their lives at the state of vitamin D deficiency because 78% of their mothers are also deficient. It was observed that treating patient vitamin D deficiency to vitamin D status serum 25(OH)D) 75–100 nmol/L increased effectiveness of therapies in infectious diseases (chronic hepatitis C, tuberculosis), osteoporosis, multiple sclerosis, epilepsy, Chronic Kidney Diseases and atopic dermatitis. . For these reasons doctors should take special attension to vitamin D status in patients suffering for these diseases properly implementing recent vitamin D recommendation.

Polymorphism 1936A&gt;G in the AKAP10 gene (encoding A-kinase-anchoring protein 10) is associated with higher cholesterol cord blood concentration in Polish full-term newborns

A-Kinase anchoring proteins (AKAPs) coordinate the specificity of protein kinase A signaling by localizing the kinase to subcellular sites. The 1936G (V646) AKAP10 allele has been associated with adults with low cholinergic/vagus nerve sensitivity and with newborns with increased blood pressure. Decreased activity of the parasympathetic system is associated with risk of metabolic syndrome. The aim of this study was to answer the question of whether 1936A > G AKAP10 polymorphism is associated with metabolic changes in full-term newborns that are predictive factors for the metabolic phenotype in adulthood. The study included 114 consecutive healthy Polish newborns born after the end of the 37 th week of gestation to healthy women with uncomplicated pregnancies. At birth, cord blood of neonates was obtained for isolation of genomic DNA and cholesterol as well as triglyceride concentration. The cholesterol level in homozygotes GG was significantly higher than that in 1936A variant carriers (AG + AA, recessive mode of inheritance). Our results demonstrate a possible association between the 1936G AKAP10 variant and the total cholesterol level in the cord blood of the Polish newborn population.

Association of 1936A > G in AKAP10 (A-kinase anchoring protein 10) and blood pressure in Polish full-term newborns

Objective. The 1936G AKAP10 allele is associated with increased adult basal heart rate (HR) and decreased variability, markers of low cholinergic/vagus sensitivity associated with hypertension. Blood pressure (BP) values in newborns are important measurable markers of cardiovascular risk later in life. The question was whether decreased vagal function-related 1936A > G AKAP10 is associated with newborn BP. Study design. 114 healthy Polish newborns born after 37th gestational week to healthy women with uncomplicated pregnancies. At birth, newborn cord blood obtained for isolation of genomic DNA. BP and HR measured on days 1 and 3 after delivery. Results. Diastolic BP on day 3 and absolute and relative differences between diastolic BP values, as well as between mean BP values on day 3 and on day 1 after birth, in carriers of 1936G AKAP10 allele, were significantly higher as compared with wild-type homozygotes. Conclusion. Results demonstrate possible association between 1936G AKAP10 variant and BP in Polish newborns.

An insertion/deletion ACE polymorphism and kidney size in Polish full-term newborns

The number of nephrons is a multifactorial trait controlled by the interaction of environmental factors and genetic variants that influence the extent of branching nephrogenesis during foetal life. A correlation between renal mass and nephron number in newborns allows the use of the total kidney volume at birth as a surrogate for congenital nephron number. Since the renin-angiotensin system plays an important role in renal development we hypothesized that the common, functional insertion/deletion (I/D) polymorphism in the ACE gene might be responsible for the variation in kidney size amongst healthy individuals. We recruited 210 healthy Polish full-term newborns born to healthy women with uncomplicated pregnancies. The kidney volume was measured sonographically. Total kidney volume (TKV) was calculated as the sum of left kidney volume and right kidney volume. TKV was normalized to body surface area (TKV/BSA). The I and D alleles were identified using polymerase chain reaction. TKV/BSA in newborns carrying at least one insertion ACE allele was significantly reduced by approximately 8% as compared with homozygous newborns for the D allele (DD genotype) (105.1±23.6 vs. 114.2±28.2 cm(3)/m(2), p<0.05). The results of this study suggest that I/D ACE polymorphism may account for subtle variation in kidney size at birth, which reflects congenital nephron endowment.

Abstract 2643: Interactions between polycyclic aromatic hydrocarbon exposure and genetic polymorphisms on benzo(a)pyrene-DNA adducts in a Polish cohort of mothers and newborns

Abstract Background Polycyclic aromatic hydrocarbons (PAHs) are a class of chemicals common in the environment. Major sources of PAHs include fossil fuel combustion and cigarette smoking. Certain PAHs are carcinogenic, though the degree to which genetic variation influences susceptibility to PAH exposure remains unclear. Benzo(a)pyrene (BaP) is a well-studied PAH that is classified as a probable human carcinogen. Here, we evaluated single nucleotide polymorphism (SNP) frequency in genes related to PAH metabolism and detoxification, and explored the interactions between PAH exposure and SNPs on BaP-DNA adducts, an established cancer risk marker, in umbilical cord white blood cells (WBCs). Methods Maternal and umbilical cord blood were collected at delivery from participants in a longitudinal cohort study of Polish mothers and newborns in Krakow, Poland. WBC DNA was isolated from cord blood, and genetic polymorphisms and BaP-DNA cord adducts were then measured in 503 mothers and 445 newborns. Maternal PAH exposure was measured during pregnancy with a personal air exposure monitor. For this study 7 maternal and newborn genes related to PAH metabolism, detoxification and repair were selected for SNP analyses: CYP1A1, CYP1A2, CYP1B1, GSTM3, GSTT2, NQO1 and XRCC1. SNP x PAH interactions on logarithmic (ln)-transformed BaP-DNA adduct levels were explored. Results We observed a number of significant interactions between high PAH exposure and SNPs in both mothers and newborns on BaP-DNA adducts in cord blood. For example, the interaction between a CYP1A2 SNP (rs2069514) and high PAH exposure on cord BaP-DNA adducts in newborns was significant (α=−1.34, p&amp;lt;0.01). We will present significant interaction results from analyses performed on both maternal and newborn CYP1A1, CYP1A2, GSTM3, GSTT2, NQO1 and XRCC1 SNPs. Discussion It is biologically plausible that an individual's abilities to metabolically activate and detoxify BaP and repair DNA damage play a role in susceptibility to DNA adduct formation following prenatal PAH exposure. Ultimately, this susceptibility could correlate with future risk of cancer development. Our findings of several SNP x PAH exposure interactions on cord BaP-DNA adducts support the hypothesis that genetic variability can contribute to susceptibility and potential cancer risk from prenatal PAH exposures. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2643. doi:1538-7445.AM2012-2643

Frequencies of functional caspase 12 genotypes in the North-Africa population

Caspase 12(Csp-12) is a cysteine protease that plays a role in regulation of cytokine maturation. It is present either in a functional full-length variant (Csp-12L) that predisposes to a lower immune response or in an inactive, common version (Csp-12S) that contains a stop codon that results in a truncated form. Genomic DNA from unrelated North Africans, residents of 4th Nile Cataract Region in Sudan, was analyzed. One hundred umbilical blood samples of Polish newborns served as a reference group from the Caucasian population. The analysis of stop-codon polymorphism performed on the 212 human samples from Northern Sudan identified 6.6% individuals with heterozygous genotypes while not one homozygous Csp-12L was found. All examined Polish individuals were homozygous Csp-12S.

Distribution of UL144, US28 and UL55 genotypes in Polish newborns with congenital cytomegalovirus infections

Human cytomegalovirus (HCMV) is the most common congenital infection. HCMV strains display genetic variability in different regions. Distribution of HCMV genotypes in the population of congenitally infected newborns from Central Poland and viral load in newborns' blood is described and discussed. HCMV isolates were analysed by sequencing at three sites on the genome: the UL144 tumour necrosis factor-alpha (TNFα)-like receptor gene, the US28 beta-chemokine receptor gene and the UL55 envelope glycoprotein B (gB) gene. The newborns' blood was examined for HCMV DNA with a nested (UL144, UL55) or heminested (US28) polymerase chain reaction, and the genotypes were determined by sequence analysis. HCMV DNA was detectable in 25 out of 55 examined newborns born by HCMV-infected mothers (45.5%). The blood viral load in mother-infant pairs was determined. Most of the newborns had identical virus genotype, gB2 (96%), UL144 B1 (88%) and US28 A2 (84%). These genotypes were detected in all newborns with asymptomatic congenital infection. The occurrence of UL144 B1 or US28 A2 genotypes in the babies examined was significant in comparison to other genotypes (p=0.0002 and p=0.040 respectively). There was no association between specific gB subtypes in all patients groups (p=0.463). There was no correlation between HCMV genotypes and the outcome.