출생 후 거대세포바이러스에 감염된 미숙아의 청력 및 뇌신경 발달 (Hearing and Neurodevelopmental Outcomes in Preterm Infants with Postnatal Cytomegalovirus Infection)

서지정보

· 발행기관 : 대한주산의학회
· 수록지 정보 : Perinatology / 33권 / 2호 / 89 ~ 95페이지
· 저자명 : 김유진, 신승한, 김이경, 김한석

초록

Objective: We aimed to investigate whether preterm infants with postnatal cytomegalovirus (CMV) infection have unfavorable hearing and neurodevelopmental outcomes. We also tried to find the difference between symptomatic and asymptomatic group of preterm infants with CMV infection.
Methods: Preterm infants born before 32 weeks’ gestation between January, 2014 and October, 2020 with urine CMV polymerase chain reaction-positive 2 weeks after birth were enrolled. Those who presented more than one of symptoms including thrombocytopenia, neutropenia, hepatitis, cholestasis, and pneumonitis were classified as a symptomatic group. Hearing status and neurodevelopmental outcomes were compared between symptomatic and asymptomatic groups by using results of auditory brainstem response threshold and Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) performed at 8 to 12 and 18 to 24-months corrected age, respectively.
Results: Among 553 live births, 32 patients (5.8%) were diagnosed as postnatal CMV infection. Of 32 patients, 20 (62.5%) were classified as a symptomatic group. The incidence of respiratory distress syndrome was significantly higher in symptomatic group (95.0 vs. 58.3%, P=0.018). Composite scores of cognitive, language, and motor domains of Bayley-III was comparable between 2 groups. Total of 2 patients showed mild hearing impairment and one of each was included in the group.
Conclusion: No significant difference in short-term outcome was observed between symptomatic and asymptomatic groups. Postnatal CMV infection in preterm infants resulted in mild degree of auditory impairment and no unfavorable neurodevelopmental outcome. Further study with large study population is needed to confirm the consequences of postnatal CMV infection among preterm infants.

영어초록

Objective: We aimed to investigate whether preterm infants with postnatal cytomegalovirus (CMV) infection have unfavorable hearing and neurodevelopmental outcomes. We also tried to find the difference between symptomatic and asymptomatic group of preterm infants with CMV infection.
Methods: Preterm infants born before 32 weeks’ gestation between January, 2014 and October, 2020 with urine CMV polymerase chain reaction-positive 2 weeks after birth were enrolled. Those who presented more than one of symptoms including thrombocytopenia, neutropenia, hepatitis, cholestasis, and pneumonitis were classified as a symptomatic group. Hearing status and neurodevelopmental outcomes were compared between symptomatic and asymptomatic groups by using results of auditory brainstem response threshold and Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) performed at 8 to 12 and 18 to 24-months corrected age, respectively.
Results: Among 553 live births, 32 patients (5.8%) were diagnosed as postnatal CMV infection. Of 32 patients, 20 (62.5%) were classified as a symptomatic group. The incidence of respiratory distress syndrome was significantly higher in symptomatic group (95.0 vs. 58.3%, P=0.018). Composite scores of cognitive, language, and motor domains of Bayley-III was comparable between 2 groups. Total of 2 patients showed mild hearing impairment and one of each was included in the group.
Conclusion: No significant difference in short-term outcome was observed between symptomatic and asymptomatic groups. Postnatal CMV infection in preterm infants resulted in mild degree of auditory impairment and no unfavorable neurodevelopmental outcome. Further study with large study population is needed to confirm the consequences of postnatal CMV infection among preterm infants.

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