Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection

Daniel E. Noyola, Gail J. Demmler, Christopher T. Nelson, Carol Griesser, W. Daniel Williamson, Jane T. Atkins, Judith Rozelle, Marie Turcich, Antolin Llorente, Sherry Sellers-Vinson, Ann Reynolds, James F. Bale, Paul Gerson, Martha D. Yow

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Abstract

Objective: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. Methods: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. Results: Microcephaly was the most specific predictor of mental retardation (100%; 95% CI 84.5-100) and major motor disability (92.3%; 95% CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100%; 95% CI 82.3-100) and motor disability, (100%; 95% CI 78.2-100). A highly significant (P < .001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29% of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P = .006) than those with normal hearing. Conclusions: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.

Original languageEnglish (US)
Pages (from-to)325-331
Number of pages7
JournalJournal of Pediatrics
Volume138
Issue number3
DOIs
StatePublished - Jan 1 2001

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Cytomegalovirus Infections
Tomography
Parturition
Microcephaly
Sensorineural Hearing Loss
Intellectual Disability
Head
Aptitude
Hearing
Longitudinal Studies
Cohort Studies
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Noyola, D. E., Demmler, G. J., Nelson, C. T., Griesser, C., Williamson, W. D., Atkins, J. T., ... Yow, M. D. (2001). Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. Journal of Pediatrics, 138(3), 325-331. https://doi.org/10.1067/mpd.2001.112061
Noyola, Daniel E. ; Demmler, Gail J. ; Nelson, Christopher T. ; Griesser, Carol ; Williamson, W. Daniel ; Atkins, Jane T. ; Rozelle, Judith ; Turcich, Marie ; Llorente, Antolin ; Sellers-Vinson, Sherry ; Reynolds, Ann ; Bale, James F. ; Gerson, Paul ; Yow, Martha D. / Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. In: Journal of Pediatrics. 2001 ; Vol. 138, No. 3. pp. 325-331.
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abstract = "Objective: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. Methods: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. Results: Microcephaly was the most specific predictor of mental retardation (100{\%}; 95{\%} CI 84.5-100) and major motor disability (92.3{\%}; 95{\%} CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100{\%}; 95{\%} CI 82.3-100) and motor disability, (100{\%}; 95{\%} CI 78.2-100). A highly significant (P < .001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29{\%} of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P = .006) than those with normal hearing. Conclusions: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.",
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Noyola, DE, Demmler, GJ, Nelson, CT, Griesser, C, Williamson, WD, Atkins, JT, Rozelle, J, Turcich, M, Llorente, A, Sellers-Vinson, S, Reynolds, A, Bale, JF, Gerson, P & Yow, MD 2001, 'Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection', Journal of Pediatrics, vol. 138, no. 3, pp. 325-331. https://doi.org/10.1067/mpd.2001.112061

Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. / Noyola, Daniel E.; Demmler, Gail J.; Nelson, Christopher T.; Griesser, Carol; Williamson, W. Daniel; Atkins, Jane T.; Rozelle, Judith; Turcich, Marie; Llorente, Antolin; Sellers-Vinson, Sherry; Reynolds, Ann; Bale, James F.; Gerson, Paul; Yow, Martha D.

In: Journal of Pediatrics, Vol. 138, No. 3, 01.01.2001, p. 325-331.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection

AU - Noyola, Daniel E.

AU - Demmler, Gail J.

AU - Nelson, Christopher T.

AU - Griesser, Carol

AU - Williamson, W. Daniel

AU - Atkins, Jane T.

AU - Rozelle, Judith

AU - Turcich, Marie

AU - Llorente, Antolin

AU - Sellers-Vinson, Sherry

AU - Reynolds, Ann

AU - Bale, James F.

AU - Gerson, Paul

AU - Yow, Martha D.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Objective: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. Methods: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. Results: Microcephaly was the most specific predictor of mental retardation (100%; 95% CI 84.5-100) and major motor disability (92.3%; 95% CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100%; 95% CI 82.3-100) and motor disability, (100%; 95% CI 78.2-100). A highly significant (P < .001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29% of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P = .006) than those with normal hearing. Conclusions: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.

AB - Objective: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. Methods: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. Results: Microcephaly was the most specific predictor of mental retardation (100%; 95% CI 84.5-100) and major motor disability (92.3%; 95% CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100%; 95% CI 82.3-100) and motor disability, (100%; 95% CI 78.2-100). A highly significant (P < .001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29% of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P = .006) than those with normal hearing. Conclusions: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.

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Noyola DE, Demmler GJ, Nelson CT, Griesser C, Williamson WD, Atkins JT et al. Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. Journal of Pediatrics. 2001 Jan 1;138(3):325-331. https://doi.org/10.1067/mpd.2001.112061