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9/26/2014  |   9:30 AM - 10:00 AM   |  Topical Session 1   |  Ballroom B

Short-term-intermediate follow-up of infants born with congenital CMV after primary maternal infection detected by positive amniotic fluid and normal fetal imaging

Most women prefer to terminate their pregnancy if CMV was isolated from amniotic fluid. Recently, significant advances in diagnosing fetal brain abnormalities by ultrasound (US) and fetal brain MRI have been achieved. Hence, when imaging studies are normal, some women continue their pregnancy despite isolation of CMV from the amniotic fluid. Aims: To evaluate the postnatal state of infants born to mothers with positive CMV found in the amniotic fluid after a primary infection, during the first and second trimester, and the short-term intermediate follow up. Methods: All infants, born to these mothers, older than a year in January 2014, were included. Urine culture, CBC, liver function, fundoscopy, brain US and sensory neural hearing loss (SNHL) evaluation were performed. Hearing follow-up was performed every 3-6 months through age 5. Neurological and developmental assessments were performed at each visit. A subgroup of 27 patients, aged 1-3, were assessed by the Bayley Scales. Results: 98 infants were included; 57 (58.2%) with CNS signs or symptoms were treated with an anti-viral agent. In 52 infants, indications for early treatment were: abnormal US findings in 46/52 (88.5%); in 10 of these cases SNHL was detected, 6 were treated due to SNHL. Another 5 cases with late onset hearing loss were also treated. Mean duration follow up was 35.1±16.1 months; 8 children (10 ears) exhibited hearing loss at the last hearing assessment, 2 of them underwent a cochlear implant. All 98 children attended regular educational institutions; 2 infants experienced mild motor delays. The mean mental developmental index assessed by the Bayley Scales was 102.6 ±10.3 (range 85-127). Conclusions: This study demonstrated that the outcome of infected infants of mothers with a primary CMV infection during the first and second trimester and normal fetal imaging is good with a low rate of sequela.

Jacob Amir (Primary Presenter), amirj@clalit.org.il;
Born in Israel. Medical studies: Hebrew University, Hadassah School of Medicine Jerusalem, Israel. Residency: Department of Pediatrics, Rabin Medical Center, Beilinson Hospital, Petach Tiqva, Israel. 1987-1989 - Fellowship: Children’s Hospital, Washington University, St. Louis, Mo, USA in Pediatric Infectious Diseases Professor of Clinical Pediatrics, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel Since 1998 - Head, Department of Pediatrics “C”, Schneider Children’s Medical Center of Israel, Petach Tiqva, Israel. Consultant for intrauterine infections at the Department of Obstetrics and Gynecology, Rabin Medical Center, Beilinson Hospital, Petach Tiqva, Israel. Main topics of clinical research include: HIB vaccine, nontuberculous lymphadenitis, post circumcision urinary tract infections, herpetic gingivostomatitis and congenital CMV infection- maternal consultation during pregnancy and post natal antiviral therapy.

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316JacobAmir.pdf

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