Neurological and growth outcomes in South African children with congenital cytomegalovirus: A cohort study

PLoS One. 2020 Sep 17;15(9):e0238102. doi: 10.1371/journal.pone.0238102. eCollection 2020.

Abstract

Objectives: To assess neurological sequelae and growth in the first 12 months of life in a cohort of congenital cytomegalovirus (cCMV) infected infants compared to cCMV uninfected infants.

Study design: This was a prospective matched cohort study conducted in Soweto, South Africa where forty-six confirmed cCMV cases were matched on HIV-exposure, gender and gestational age (±two weeks) to 84 cCMV-uninfected controls in a 1:2 ratio. Cases and controls were followed up until 12 months of age to assess anthropometry, hearing and neurodevelopmental outcomes.

Results: Thirty-four (73.9%) cCMV cases and 74 (88.1%) controls, completed all assessments at 12 months age. At 12 months, one cCMV case had died, none of the children in either group had SNHL and neurodevelopmental delay was present in a similar percentage of cCMV cases (n = 2; 6%) and controls (n = 1, 4%; OR 1.09, 95% CI 0.04-27.84, p = 0.958). Anthropometry did not differ between cases and controls overall throughout the follow up period. HIV-exposed cases had smaller head circumference for age at 6 and 12 months when compared with HIV-exposed controls.

Conclusion: By 12 months of age, there was no evidence of a difference in neurological sequelae between cCMV infected South African children and cCMV uninfected children in this study. Further follow-up is warranted to detect late-onset hearing loss and neurodevelopmental delay beyond 12 months of age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / diagnostic imaging
  • Cytomegalovirus Infections / physiopathology*
  • Female
  • Growth and Development*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nervous System Diseases / complications*
  • Pregnancy
  • South Africa
  • Ultrasonography
  • Young Adult

Grants and funding

SAM received funding for this study from the South African Medical Research Council and The South African Research Chairs Initiative (SARChI), Grant number: UID 64797. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. https://www.nrf.ac.za/division/rcce/instruments/research-chairs.