Background: Cytomegalovirus infection is the most common cause of congenital infection, the most common non-genetic cause of childhood sensorineural hearing loss and an important cause of neurodevelopmental delay. While data on vertical transmission and neonatal outcome after singleton pregnancy is well established, only scarce reports have addressed congenital CMV (cCMV) in multiple birth pregnancies. Furthermore, no studies have as yet compared the outcome after birth and long- term follow up of children with cCMV born after a singleton vs. multiple pregnancy.
Patients and Methods: Data of all infants with cCMV infection between 2005 and 2015 were reviewed. Infant outcome after birth of symptomatic vs. asymptomatic disease was compared between infants born after multiple (study group) and singleton (control group) pregnancies in a 1:2 ratio.
Results: Out of 508 infants diagnosed with cCMV in our clinic, 25 (4.9%) were born after a multiple pregnancy. Children in the study and control groups did not differ in terms of specific prenatal CMV investigations including amniocentesis and brain magnetic resonance imaging studies. There was a higher rate of symptomatic cCMV infection in the study group than in the controls (48% vs.14%, p<0.001). Hearing impairment at birth was also more frequent in the study group (32% vs. 8%, p=0.016). The rate of other central nervous system manifestations and non- central nervous system manifestations, were not statistically different between the groups at birth. A long-term follow up demonstrated that children in the study group had higher rates of neurological sequelae (hearing impairment or neurodevelopmental delay) compared to children in the control group (20% vs. 4%, p=0.016).
Conclusions: Infants with cCMV born after multiple birth pregnancies have a higher risk of symptomatic disease at birth and worse long-term neurological outcome than those born after a singleton pregnancy. This important group of children warrants meticulous prenatal and postnatal care.
