Skip to main content

Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight.

Publication ,  Journal Article
Weimer, KED; Kelly, MS; Permar, SR; Clark, RH; Greenberg, RG
Published in: JAMA Pediatr
February 1, 2020

IMPORTANCE: Studies suggest that postnatal cytomegalovirus (CMV) infection can lead to long-term morbidity in infants with very low birth weight (VLBW; <1500 g), including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and neurodevelopmental impairment. However, to date, the association of postnatal CMV with hearing, growth, and length of stay among VLBW infants is unknown. OBJECTIVES: To determine the risk for failed hearing screen, increased postnatal age at discharge, or decreased growth at discharge in VLBW infants with postnatal CMV infection compared with CMV-uninfected infants and to compare the risk for other major outcomes of prematurity, including BPD and NEC, in infants with and without postnatal CMV infection. PARTICIPANTS: This multicenter retrospective cohort study included VLBW infants from 302 neonatal intensive care units managed by the Pediatrix Medical Group from January 1, 2002, through December 31, 2016. Infants hospitalized on postnatal day 21 with a diagnosis of postnatal CMV and hearing screen results after a postmenstrual age of 34 weeks were included in the study population. Data were analyzed from December 11, 2017, to June 14, 2019. MAIN OUTCOMES AND MEASURES: Infants with and without postnatal CMV infection were matched using propensity scores. Poisson and linear regression were used to examine the association between postnatal CMV and the risk of failed hearing screen, postnatal age at discharge, growth, BPD, and NEC. RESULTS: A total of 304 infants with postnatal CMV were identified, and 273 of these infants (89.8%; 155 boys [56.8%]) were matched with 273 infants without postnatal CMV (148 boys [54.2%]). Hearing screen failure occurred in 45 of 273 infants (16.5%) with postnatal CMV compared with 25 of 273 infants (9.2%) without postnatal CMV (risk ratio [RR], 1.80; 95% CI, 1.14 to 2.85; P = .01). Postnatal CMV was also associated with an increased postnatal age at discharge of 11.89 days (95% CI, 6.72 to 17.06 days; P < .001) and lower weight-for-age z score (-0.23; 95% CI, -0.39 to -0.07; P = .005). Analysis confirmed an increased risk of BPD (RR, 1.30; 95% CI, 1.17 to 1.44; P < .001), previously reported on infants from this cohort from 1997 to 2012, but not an increased risk of NEC after postnatal day 21 (RR, 2.00; 95% CI, 0.18 to 22.06; P = .57). CONCLUSIONS AND RELEVANCE: These data suggest that postnatal CMV infection is associated with lasting sequelae in the hearing and growth status of VLBW infants and with prolonged hospitalization. Prospective studies are needed to determine the full effects of postnatal CMV infection and whether antiviral treatment reduces the associated morbidity.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

February 1, 2020

Volume

174

Issue

2

Start / End Page

133 / 140

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pediatrics
  • Male
  • Length of Stay
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Hearing Disorders
  • Growth Disorders
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Weimer, K. E. D., Kelly, M. S., Permar, S. R., Clark, R. H., & Greenberg, R. G. (2020). Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight. JAMA Pediatr, 174(2), 133–140. https://doi.org/10.1001/jamapediatrics.2019.4532
Weimer, Kristin E. D., Matthew S. Kelly, Sallie R. Permar, Reese H. Clark, and Rachel G. Greenberg. “Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight.JAMA Pediatr 174, no. 2 (February 1, 2020): 133–40. https://doi.org/10.1001/jamapediatrics.2019.4532.
Weimer KED, Kelly MS, Permar SR, Clark RH, Greenberg RG. Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight. JAMA Pediatr. 2020 Feb 1;174(2):133–40.
Weimer, Kristin E. D., et al. “Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight.JAMA Pediatr, vol. 174, no. 2, Feb. 2020, pp. 133–40. Pubmed, doi:10.1001/jamapediatrics.2019.4532.
Weimer KED, Kelly MS, Permar SR, Clark RH, Greenberg RG. Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight. JAMA Pediatr. 2020 Feb 1;174(2):133–140.

Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

February 1, 2020

Volume

174

Issue

2

Start / End Page

133 / 140

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pediatrics
  • Male
  • Length of Stay
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Hearing Disorders
  • Growth Disorders
  • Female