Predicting mid-term hearing and developmental outcome in clinically inapparent congenital cytomegalovirus infection with hearing loss at birth

Early Human Development, vol. 211, pp. 106412

Abstract

OBJECTIVE: To assess the predictive value of clinical factors in children with clinically inapparent congenital cytomegalovirus infection (cCMV) and sensorineural hearing loss, for hearing and neurodevelopmental outcome. STUDY DESIGN: This was a post hoc analysis of data from a nonrandomized trial performed in 37 infants (25 treated with 6 weeks valganciclovir, 12 controls) with cCMV and hearing loss, diagnosed after failing Newborn Hearing Screening. Candidate predictors were head circumference, birth weight, gestational age, neuroimaging results, and baseline hearing loss laterality. The primary outcome was the absolute change in hearing in the best ear (dB) from baseline to follow-up at 18-22 months. Secondary outcomes included change in hearing per ear ('total-ear' analysis) and neurodevelopmental outcomes measured by the Bayley Scales of Infant Development (BSID-III) at 18-22 months. Per candidate factor, bivariate linear regression models adjusted for treatment were performed. RESULTS: No correlations were found between candidate predictors and the primary hearing outcome. Linear correlations were observed for neurodevelopmental outcomes: severity of neuroimaging abnormalities was associated with cognitive and motor BSID-III scores (both P < 0.001) and head circumference with motor score (P < 0.001). No severe motor delay was seen in children with a head circumference above -1 SD, and infants with mild or moderate neuroimaging abnormalities generally had normal development or mild delay. Severe cognitive and motor delays were observed only in those with severe neuroimaging findings. CONCLUSIONS: In children with clinically inapparent cCMV and hearing loss, head circumference and neuroimaging severity may be useful for predicting cognitive and motor outcomes.

Authors 4

1. Pui Khi Chung corresponding Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Center for Infectious Diseases, Medical Microbiology and Infection Control, the Netherlands. Electronic address: p.k.chung@lumc.nl

2. Fleurtje Schornagel Aachen

   Leiden University

   Affiliation as printed

   Leiden University Center for Infectious Diseases, Medical Microbiology and Infection Control, the Netherlands; SBOH, Primary Health Care Training Foundation, the Netherlands

3. Jelle J. Goeman Aachen Department of Medical Statistics

   Leiden University Medical Center

   Affiliation as printed

   Department of Medical Statistics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands

4. Ann C.T.M. Vossen Aachen

   Leiden University

   Affiliation as printed

   Leiden University Center for Infectious Diseases, Medical Microbiology and Infection Control, the Netherlands