Pediatrics and neonatology · 2026
Maternal transmission, neonatal outcomes, and predictors of adverse effects in congenital cytomegalovirus infection.
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Garozzo Maria Teresa, Pecorino Basilio, Poli Graziella, Maiolino Luigi, Sciuto Laura, Scalia Guido, Ruggieri Martino, Polizzi Agata, Praticò Andrea D
Аннотация
BACKGROUND: Congenital cytomegalovirus (cCMV) infection, caused by a DNA beta-herpesvirus, is the most common congenital infection globally, with significant neurodevelopmental and audiological sequelae. This study aimed to evaluate maternal-to-fetal transmission rates, neonatal outcomes, and the predictive value of clinical and virological markers for adverse outcomes.
METHODS: This prospective longitudinal study enrolled 43 neonates born to mothers with CMV infection during pregnancy (2019-2023). cCMV was diagnosed by CMV DNA detection in urine or saliva within the first two weeks of life. Neuroimaging, audiological evaluations, and neurodevelopmental assessments were conducted during follow-up. Statistical analyses examined associations between maternal infection type, neonatal findings, and clinical outcomes.
RESULTS: Among 43 neonates, 31 (72%) were diagnosed with cCMV. Primary maternal infection was significantly associated with higher transmission rates (p < 0.01). Twelve infected infants (38.7%) showed neurological symptoms, most commonly of speech and motor delay. SNHL was diagnosed in 2 patients (6.4%). High blood viral load was significantly associated with adverse audiological outcomes (p < 0.05), while intrauterine growth restriction (IUGR) predicted adverse neurological outcomes (p = 0.05). No statistically significant association was found between MRI abnormalities and neurological or audiological outcomes, although a trend toward correlation with adverse outcomes was observed.
CONCLUSIONS: cCMV carries a high risk of neurodevelopmental and auditory sequelae. High blood viral load and IUGR may serve as early predictors of poor outcomes. Early diagnosis, parental counseling, and long-term follow-up remain essential. Larger multicenter studies are needed to validate these findings and refine predictive models.
METHODS: This prospective longitudinal study enrolled 43 neonates born to mothers with CMV infection during pregnancy (2019-2023). cCMV was diagnosed by CMV DNA detection in urine or saliva within the first two weeks of life. Neuroimaging, audiological evaluations, and neurodevelopmental assessments were conducted during follow-up. Statistical analyses examined associations between maternal infection type, neonatal findings, and clinical outcomes.
RESULTS: Among 43 neonates, 31 (72%) were diagnosed with cCMV. Primary maternal infection was significantly associated with higher transmission rates (p < 0.01). Twelve infected infants (38.7%) showed neurological symptoms, most commonly of speech and motor delay. SNHL was diagnosed in 2 patients (6.4%). High blood viral load was significantly associated with adverse audiological outcomes (p < 0.05), while intrauterine growth restriction (IUGR) predicted adverse neurological outcomes (p = 0.05). No statistically significant association was found between MRI abnormalities and neurological or audiological outcomes, although a trend toward correlation with adverse outcomes was observed.
CONCLUSIONS: cCMV carries a high risk of neurodevelopmental and auditory sequelae. High blood viral load and IUGR may serve as early predictors of poor outcomes. Early diagnosis, parental counseling, and long-term follow-up remain essential. Larger multicenter studies are needed to validate these findings and refine predictive models.