479 - Neurobehavioral Outcomes of Neonatal Asymptomatic Congenital Cytomegalovirus Infection at 12-Months

Poster Number: 479
Publication Number: 479.343

Sally Stoyell, University of Minnesota, Minneapolis, MN, United States; Mark R. Schleiss, University of Minnesota Medical School, Division of Ped Inf Dis, Minneapolis, MN, United States; Jed T. Elison, University of Minnesota, Minneapolis, MN, United States; Emily Graupmann, University of Minnesota, Minneapolis, MN, United States; Jessica L. Emerick, University of Minnesota Medical School, Minneapolis, MN, United States; Kristin Sandness, University of Minnesota Medical School, Minneapolis, MN, United States; Erin A. Osterholm, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States

Background: Congenital cytomegalovirus (cCMV) is the most common congenital viral infection in the United States, with an estimated prevalence of 4.5 infections per 1000 live births. Symptomatic infections can cause severe hearing loss and neurological disability, although approximately 90% of cCMV infections are asymptomatic at birth (aCMV). Despite its prevalence, the long-term neurodevelopmental and behavioral risks of aCMV infections are not fully understood.

Objective: To determine the risk of long-term neurobehavioral sequelae in infants with aCMV, by comparing infants with aCMV and healthy controls using neurobehavioral assessments and parent questionnaires.

Design/Methods: Infants with CMV were identified from an ongoing universal newborn CMV screening program around the Twin Cities. Asymptomatic infants who consented to participate were then followed longitudinally through the first two years of life. Neurobehavioral assessments and parent questionnaires, including the Mullen Scales of Early Learning, the Repetitive Behavior Scales for Early Childhood (RBS-EC), and the Infant Toddler Social Emotional Assessment (ITSEA) were administered at 12 months of age (Nf25 infants with aCMV). ERP assessments and MRI scans were also collected at this age. Age- and sex-matched healthy control infants were identified from the Baby Connectome Project (BCP), a longitudinal study of brain and behavior of infants 0-5 years that includes MRI scans and neurobehavioral assessments. From the BCP, Nf116 infants with Mullen scores, Nf95 infants with RBS-EC scores, and Nf71 infants with ITSEA scores were identified. To function as comparisons for the ERP assessments, additional healthy control infants were recruited from the same registry as the BCP participants with similar inclusion criteria. These infants (Nf30) underwent the same protocol (sans MRI) as the infants with aCMV. Neurobehavioral assessment scores were compared between infants with aCMV and all identified age- and sex-matched healthy control infants.

Results: Demographic characteristics of participants are summarized in Table 1. No differences were found between infants with aCMV and healthy control infants on any of the neurobehavioral measures tested at 12 months of age (Figure 1; all p >0.1). Conclusion(s): These results indicate that at 12 months of age, infants with aCMV are not statistically different from controls in a number of behavioral domains. Although follow-up is ongoing, these observations provide reassurance about neurodevelopmental outcomes for infants with aCMV and inform the ongoing discussion around universal screening.
Stoyell CVCV_SallyStoyell.pdf
Figure 1No differences were found between aCMV infants and healthy control infants for any of the neurodevelopmental measures: A) Mullen Composite Standard Scores B) Repetitive Behavior Scales for Early Childhood (RBS-EC) Composite Endorsed Items C) Infant Toddler Social Emotional Assessment (ITSEA) subscales