308 - Disparities in diagnosing congenital cytomegalovirus infection in premature infants: The US national database

Poster Number: 308
Publication Number: 308.124

Ibrahim Qattea, Cleveland Clinic Children's, Lakewood, OH, United States; Daron L. Ross, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Naveen Kannekanti, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Noor Asi, Metrohealth Medical Center, Cleveland, OH, United States; Mohamed A. Mohamed, Cleveland Clinic Children's, Cleveland, OH, United States; Hany Aly, Cleveland Clinic Children's Hospital, Cleveland, OH, United States

Background: Congenital CMV can cause significant morbidity and mortality in premature infants. Long-term sequelae, including neurodevelopmental disabilities and sensorineural hearing loss are not uncommon. 
 

Objective: To assess prevalence and trends of congenital CMV infection in premature infants in relation with gestational age (GA) and ethnic groups. We hypothesized that CMV diagnosis is equally presented in different ethnic groups and, due to increased awareness, trends for diagnosing congenital CMV infection is increasing.   
 

Design/Methods: We utilized the de-identified national inpatient sample dataset for the years 2007-2018. The study included all premature infants (GA < 37 weeks) with postnatal age ≤28 days. Infants diagnosed with congenital CMV were identified. The prevalence rates were reported.  Trend analyses were conducted using Cochran-Armitage (CA) test for ordered alternatives. Regression analysis was performed to determine the association of congenital CMV with mortality while controlling for confounders.
 

Results: A total of 44,628,827 infants were identified; of them 3,982,478(8.9%) were preterm infants and 3525(7.9/100,000) were diagnosed with congenital CMV. Congenital CMV was increased Black population.  Table 1 provides the characteristics of the study population. Trend analyses showed a significant increase in congenital CMV with decreasing GA, p< 0.001 (Fig 1, upper panel). There was no change in congenital CMV over the years, p=0.12 (Fig 1, lower panel).  gestational age was close to term gestational age P< 0.001. Regression analysis showed increased mortality with congenital CMV (aOR=3.01; CI: 2.57-3.52, p< 0.001), Table 2. 
 Conclusion(s): Congenital CMV infection is significantly increased with decreasing GA. Disparities exist in CMV with high prevalence in Black population. Congenital CMV is associated with a three-fold increase in mortality in preterm infants.
 
Table 1.Characteristics of the study population and risk ratio of congenital CMV in preterm infants.
Table 2. Regression analysis for CMV and other factors associated with mortality in preterm infants.