Lesions of organs and systems in children born from mothers with acute cytomegalovirus infection
AbstractThe study analyzed the somatic and neurological status of newborns at birth, clinical, laboratory and instrumental monitoring of children during the first year of life with and without the presentation of congenital infections.
The aim of the study is to give a clinical and laboratory characteristic of organ and system damage in children born from mothers with acute cytomegalovirus infection (CMVI).
Material and methods. In the period from January 1, 2021 to September 30, 2021, 30 pregnant women were examined. The inclusion criteria were pregnant women with mononucleosis-like presentation (rhinitis, pharyngitis, tracheitis) from the 28th week of pregnancy and positive IgM and IgG antibodies to cytomegalovirus (CMV), their absence of Human immunodeficiency virus (HIV) infection markers.
The exclusion criteria from the study were the absence of acute respiratory viral infections (ARVI) like diseases (rhinitis, pharyngitis, tracheitis) in women from the 28th week of pregnancy and/or positive IgM and IgG antibodies to CMV and/or detection of HIV infection and/or combined infections included in the TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus infection, herpes) complex.
30 children born from this group of mothers were observed with follow-up (20 with confirmed congenital infections, 10 without congenital infection symptoms). Confirmation of the diagnosis of HIV was carried out according to the clinical guidelines “Congenital cytomegalovirus infection”, 2022.
Results. As a result of the study, acute CMVI was confirmed in 40% (n=12) of the observed pregnant women with mononucleosis-like presentation which, apparently, is due to the criteria for including patients in the study and a small sample. At birth, in the group of children with the implementation of congenital infections, severe condition was registered in 30% of cases, moderate severity – in 50%, satisfactory condition – in 20%. Anthropometric data at birth corresponded to gestational age only in 55.5% (11) of newborns with confirmed congenital infections and in 80% (8) – without congenital infection symptoms. In children with neurological symptoms, meningoencephalitis was registered in 2 (10%), mild and moderate ischemic damage to the central nervous system (CNS) in 14 (70%) children, intraventricular hemorrhages were noted in 12 (60%) children.
In children with the implementation of congenital infections in the first year of life, CNS damage was found in 13 (65%), neutropenia in almost half of cases (45%), diseases such as chorioretinitis, hepatitis, bronchopulmonary dysplasia (BPD), anemia, congenital malformations, sensorineural hearing loss occurred with a frequency of 20%, 15% (hepatitis and BPD) and 5% (anemia, congenital malformations, deafness). After the analysis of the structure of somatic pathology it was noticed that only CNS damage was significantly more often observed in children with congenital infection (φ=0.0067; p<0.05).
Conclusion. In newborns, regardless of the implementation of congenital infections, there were no significant differences (p>0.05) in the frequency of registration of respiratory distress syndrome, pneumonia, meningoencephalitis, grade I, II, III intraventricular hemorrhages and grade I, II, III cerebral ischemia.
In most cases, children with the implementation of congenital infections in the second half of life had average indicators of physical development, however, in the structure of somatic pathology in children of the first year of life, CNS damage was significantly more frequent (65%), other manifestations of congenital infections were noted in no more than 50% of cases: in 45% – neutropenia, in 20% – chorioretinitis, in 15% – hepatitis and BPD, in 5% – anemia, congenital malformations, sensorineural hearing loss.
Keywords:cytomegalovirus; pregnant women; newborns; diagnostics
Funding. The study had no sponsorship.
Conflict of interest. The authors declare that there is no conflict of interest.
Contribution. The concept and design of the study – Rogozina N.V., Vasil’ev V.V.; collection and processing of material – Rogozina N.V., Ivanova R.A., Ushakova G.M.; statistical data processing – Bezverkhaya N.S.; collection of literature data, writing text, editing – Rogozina N.V., Bezverkhaya N.S.
For citation: Rogozina N.V., Vasil’ev V.V., Ivanova R.A., Ushakova G.M., Bezverkhaya N.S. Lesions of organs and systems in children born from mothers with acute cytomegalovirus infection. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2023; 12 (2): 57–64. DOI: https://doi.org/10.33029/2305-3496-2023-12-2-57-64 (in Russian)
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