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Postnatal CMV associated with failed hearing screen, lower weight in VLBW infants

Tuesday, December 10, 2019
By Eamon Dreisbach
Rachel Greenberg

In very low-birth-weight infants, postnatal cytomegalovirus, or CMV, is associated with an increased risk for a failed hearing screen, bronchopulmonary dysplasia, increased postnatal age at discharge and decreased weight for length at discharge, according to a study published in JAMA Pediatrics.

“Since hearing impairment, growth and lung disease are all risk factors for long-term neurodevelopmental impairment, our findings raise concern that postnatal CMV infection could adversely affect long-term health and development in infants born preterm,” Rachel G. Greenberg, MD, MHS, assistant professor of pediatrics in the Division of Neonatology at Duke University Medical Center, told Healio. “CMV acquired after birth is associated with long-lasting sequelae in premature infants when they go home from the NICU, highlighting the importance of testing for this infection.”

Greenberg and colleagues compared 273 very low-birth-weight (VLBW) infants with postnatal CMV with 273 VLBW infants without the virus from 302 neonatal ICUs from Jan. 1, 2002, to Dec. 31, 2016. They included infants hospitalized at postnatal day 21 with a postnatal CMV diagnosis and hearing screen results after a postmenstrual age of 34 weeks.

Hearing screen failure occurred in 45 (16.5%) infants with CMV and 25 (9.2%) healthy infants (RR = 1.8; 95% CI, 1.14-2.85). CMV also was associated with increased postnatal age at time of discharge of 11.89 days (95% CI, 6.72-17.06 days) and a decreased weight-for-age z score of –0.23 (95% CI, –0.39 to –0.07). They also observed an increased risk for bronchopulmonary dysplasia in infants with CMV (RR = 1.3; 95% CI, 1.17-1.44), but no increased risk was observed for infants with necrotizing enterocolitis after postnatal day 21 (RR = 2; 95% CI, 0.18-22.06).

“The biggest limitation of our study was that we were not able to evaluate outcomes of infants after they were discharged from the hospital,” Greenberg said. “Failed hearing screens do not always indicate permanent hearing loss, and some infants who pass the newborn hearing screen still have hearing loss. Further studies are needed to evaluate hearing and neurodevelopmental outcomes of these infants, ideally at toddler and school age.” 

Citation: Weimer KED, Kelly MS, Permar SR, Clark RH, Greenberg RG. Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight. JAMA Pediatr. Published online December 02, 2019. doi:https://doi.org/10.1001/jamapediatrics.2019.4532


This article was originally published on Helio.