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Hearing loss in children with congenital cytomegalovirus infection born to mothers with preexisting immunity

  • Shannon A. Ross
    Correspondence
    Reprint requests: Shannon A. Ross, MD, The University of Alabama at Birmingham, CHB 304, 1600 7th Ave S, Birmingham, AL 35233.
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • Karen B. Fowler
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • Guha Ashrith
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • Sergio Stagno
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • William J. Britt
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • Robert F. Pass
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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  • Suresh B. Boppana
    Affiliations
    From the Departments of Pediatrics, Epidemiology, Maternal and Child Health, and Microbiology, University of Alabama at Birmingham and the Department of Medicine, University of Texas, Houston.
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      Objective

      To define hearing outcomes in children with congenital cytomegalovirus (CMV) infection born to mothers with non-primary CMV infection.

      Study design

      A cohort of 300 children with congenital CMV infection identified by newborn virologic screening at the University of Alabama Hospital and a private community hospital in which the type of maternal infection could be classified constituted the study population. Maternal infections were categorized by analyzing serum samples. Children were followed prospectively and underwent serial audiologic evaluations.

      Results

      The frequency of hearing loss was not different between children born to mothers with non-primary infection (10%) and those with primary infection (11%). Significantly more children in the primary infection group had progressive and severe/profound hearing loss compared with children in the non-primary group. The frequency of bilateral, delayed onset, high-frequency, and fluctuating hearing loss was not different between the 2 groups. The mean age of diagnosis of hearing loss was 39 ± 53 months for children born to mothers with non-primary infection and 13 ± 21 months for the primary infection group (P = .16).

      Conclusions

      Maternal preexisting seroimmunity to CMV does not provide complete protection against hearing loss in infants with congenital CMV infection.
      CMV (Cytomegalovirus), dB (Decibels), IgG (Immunoglobulin G), IgM (Immunoglobulin M), SNHL (Sensorineural hearing loss)
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      References

        • Stagno S.
        Cytomegalovirus.
        in: Remington J.S. Klein J.O. Infectious diseases of the fetus and newborn infant. 5th ed. WB Saunders, Philadelphia1995: 389-424
        • Demmler G.J.
        Infectious Diseases Society of America and Centers for Disease Control.
        Rev Infect Dis. 1990; 13: 315-329
        • Boppana S.B.
        • Pass R.F.
        • Britt W.J.
        • Stagno S.
        • Alford C.A.
        Symptomatic congenital cytomegalovirus infection.
        Pediatr Infect Dis J. 1992; 11: 93-99
        • Fowler K.B.
        • Stagno S.
        • Pass R.F.
        • Britt W.J.
        • Boll T.J.
        • Alford C.A.
        The outcome of congenital cytomegalovirus infection in relation to maternal antibody status.
        N Engl J Med. 1992; 326: 663-667
        • Ahlfors K.
        • Ivarsson S.A.
        • Harris S.
        Report on a long-term study of maternal and congenital cytomegalovirus infection in Sweden. review of prospective studies available in the literature.
        Scand J Infect Dis. 1999; 31: 443-457
        • Harris S.
        • Ahlfors K.
        • Ivarsson S.A.
        • Lernmark B.
        • Svanberg L.
        Congenital cytomegalovirus infection and sensorineural hearing loss.
        Ear Hear. 1984; 5: 352-355
        • Williamson W.D.
        • Demmler G.J.
        • Percy A.K.
        • Catlin F.I.
        Progressive hearing loss in infants with asymptomatic congenital cytomegalovirus infection.
        Pediatrics. 1992; 90: 862-866
        • Fowler K.B.
        • McCollister F.P.
        • Dahle A.J.
        • Boppana S.B.
        • Britt W.J.
        • Pass R.F.
        Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection.
        J Pediatr. 1997; 130: 624-630
        • Barbi M.
        • Binda S.
        • Caroppo S.
        • Ambrosetti U.
        • Corbetta C.
        • Sergi P.
        A wider role for congenital cytomegalovirus infection in sensorineural hearing loss.
        Pediatr Infect Dis J. 2003; 22: 39-42
        • Dahle A.J.
        • Fowler K.B.
        • Wright J.D.
        • Boppana S.B.
        • Britt W.J.
        • Pass R.F.
        Longitudinal investigations of hearing disorders in children with congenital cytomegalovirus.
        J Am Acad Audiol. 2000; 11: 283-290
        • Stagno S.
        • Reynolds D.W.
        • Huang E.-S.
        • Thames S.D.
        • Smith R.J.
        • Alford C.A.
        Congenital cytomegalovirus infection.
        N Engl J Med. 1977; 296: 1254-1258
        • Fowler K.B.
        • Stagno S.
        • Pass R.F.
        Maternal immunity and prevention of congenital cytomegalovirus infection.
        JAMA. 2003; 289: 1008-1011
        • Stagno S.
        • Pass R.F.
        • Dworsky M.E.
        • Henderson R.E.
        • Moore E.G.
        • Walton P.D.
        • et al.
        Congenital cytomegalovirus infection.
        N Engl J Med. 1982; 306: 945-949
        • Ahlfors K.
        • Ivarsson S.A.
        • Johnsson T.
        • Svanberg L.
        Primary and secondary maternal cytomegalovirus infections and their relation to congenital infection. Analysis of maternal sera.
        Acta Paediatr Scand. 1982; 71: 109-113
        • Ahlfors K.
        • Ivarsson S.A.
        • Harris S.
        • Svanberg L.
        • Holmqvist R.
        • Lernmark B.
        • et al.
        Congenital cytomegalovirus infection and disease in Sweden and the relative importance of primary and secondary maternal infections. Preliminary findings from a prospective study.
        Scand J Infect Dis. 1984; 16: 129-137
        • Morris D.J.
        • Sims D.
        • Chiswick M.
        • Das V.K.
        • Newton V.E.
        Symptomatic congenital cytomegalovirus infection after maternal recurrent infection.
        Pediatr Infect Dis J. 1994; 13: 61-64
        • Boppana S.B.
        • Fowler K.B.
        • Britt W.J.
        • Stagno S.
        • Pass R.F.
        Symptomatic congenital cytomegalovirus infection in infants born to mothers with preexisting immunity to cytomegalovirus.
        Pediatrics. 1999; 104: 55-60
        • Gaytant M.A.
        • Rours J.I.J.G.
        • Steegers E.A.P.
        • Galama J.M.D.
        • Semmekrot B.A.
        Congenital cytomegalovirus infection after recurrent infection.
        Eur J Pediatr. 2003; 162: 248-253
        • Stagno S.
        • Pass R.F.
        • Cloud G.
        • Britt W.J.
        • Henderson R.E.
        • Walton P.D.
        • et al.
        Primary Cytomegalovirus Infection in Pregnancy.
        JAMA. 1986; 256: 1904-1908
        • Balcarek K.B.
        • Warren W.
        • Smith R.J.
        • Lyon M.D.
        • Pass R.F.
        Neonatal screening for congenital cytomegalovirus infection by detection of virus in saliva.
        J Infect Dis. 1993; 30: 1433-1436
        • Boppana S.B.
        • Smith R.
        • Stagno S.
        • Britt W.J.
        Evaluation of a microtiter plate fluorescent antibody assay for rapid detection of human cytomegalovirus infections.
        J Clin Microbiol. 1992; 30: 721-723
        • Bratcher D.F.
        • Bourne N.
        • Bravo F.J.
        • Schleiss M.R.
        • Slaoui M.
        • Myers M.G.
        • et al.
        Effect of passive antibody on congenital cytomegalovirus infection in guinea pigs.
        J Infect Dis. 1995; 172: 944-950
        • Harrison C.J.
        • Britt W.J.
        • Chapman N.M.
        • Mullican J.
        • Tracy S.
        Reduced congenital cytomegalovirus (CMV) infection after maternal immunization with a guinea pig CMV glycoprotein before gestational primary CMV infection in the guinea pig model.
        J Infect Dis. 1995; 172: 1212-1220
        • Woolf N.K.
        • Harris J.P.
        • Ryan A.F.
        • Butler D.M.
        • Richman D.D.
        Hearing loss in experimental cytomegalovirus infection of the guinea pig inner ear.
        Ann Otol Rhinol Laryngol. 1985; 94: 350-356
        • Harris J.P.
        • Fan J.T.
        • Keithley E.M.
        Immunologic responses in experimental cytomegalovirus labyrinthitis.
        Am J Otolaryngol. 1990; 11: 304-308
        • Griffiths P.D.
        • Stagno S.
        • Pass R.F.
        • Smith R.J.
        • Alford Jr, C.A.
        Infection with cytomegalovirus during pregnancy.
        J Infect Dis. 1982; 145: 647-653
        • Stagno S.
        • Tinker M.K.
        • Elrod C.
        • Fuccillo D.A.
        • Cloud G.
        • O’Beirne A.J.
        Immunoglobulin M antibodies detected by enzyme-linked immunosorbent assay and radioimmunoassay in the diagnosis of cytomegalovirus infections in pregnant women and newborn infants.
        J Clin Microbiol. 1985; 21: 930-935

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