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Karen B Fowler - One of the best experts on this subject based on the ideXlab platform.
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congenital Cytomegalovirus Infection
Seminars in Perinatology, 2018Co-Authors: Karen B Fowler, Suresh B BoppanaAbstract:Each year, thousands of children are born with or develop permanent disabilities such as hearing loss, vision loss, motor and cognitive deficits from congenital CMV Infection (cCMV). However, awareness of cCMV and its associated sequelae is very low in pregnant women and healthcare providers. Both targeted and universal approaches to screen newborns for CMV Infection are now achievable due to recent scientific advances including the development of a rapid, high-throughput method for detecting CMV in saliva, the efficacy of antiviral treatment in symptomatic infants, and the demonstration of cost effectiveness of CMV screening. Future studies are needed to address gaps in our understanding on the role of non-primary maternal CMV Infections, the evaluation of antiviral treatment in asymptomatic infants, and the implementation of prevention strategies for cCMV.
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congenital Cytomegalovirus Infection in pregnancy and the neonate consensus recommendations for prevention diagnosis and therapy
Lancet Infectious Diseases, 2017Co-Authors: William D. Rawlinson, David W Kimberlin, Sophie Alain, Kate Daly, Sara Doutre, Laura Gibson, Tiziana Lazzarotto, Karen B Fowler, Suresh B Boppana, Michelle L. GilesAbstract:Summary Congenital Cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal Infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital Cytomegalovirus. Data in the literature suggest that congenital Cytomegalovirus Infection remains a research priority, but data are yet to be translated into clinical practice. An informal International Congenital Cytomegalovirus Recommendations Group was convened in 2015 to address these questions and to provide recommendations for prevention, diagnosis, and treatment. On the basis of consensus discussions and a review of the literature, we do not support universal screening of mothers and the routine use of Cytomegalovirus immunoglobulin for prophylaxis or treatment of infected mothers. However, treatment guidelines for infected neonates were recommended. Consideration must be given to universal neonatal screening for Cytomegalovirus to facilitate early detection and intervention for sensorineural hearing loss and developmental delay, where appropriate. The group agreed that education and prevention strategies for mothers were beneficial, and that recommendations will need continual updating as further data become available.
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clinical predictors of sensorineural hearing loss and cognitive outcome in infants with symptomatic congenital Cytomegalovirus Infection
Pediatric Infectious Disease Journal, 2016Co-Authors: Swetha G Pinninti, Karen B Fowler, Suresh B Boppana, Zdenek Novak, William J Britt, Shannon A RossAbstract:The objective of this study was to determine newborn clinical findings predictive of adverse clinical outcomes in infants with symptomatic congenital Cytomegalovirus Infection. Of 160 infants, significantly more children with central nervous system involvement had sensorineural hearing loss (P = 0.0
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risk factors for congenital Cytomegalovirus Infection in the offspring of young women exposure to young children and recent onset of sexual activity
Pediatrics, 2006Co-Authors: Karen B Fowler, Robert F PassAbstract:OBJECTIVE. Two recognized sources of maternal Cytomegalovirus Infection are young children and sexual activity. Previous studies evaluated either maternal exposures to young children or sexual activity, but these studies did not evaluate whether both of these maternal Cytomegalovirus sources contribute to increases in congenital Cytomegalovirus Infections within populations with a high prevalence of Infection among women of childbearing age. Our objective with this study was to investigate whether maternal Cytomegalovirus exposure through young children and by sexual activity increases the risk for congenital Cytomegalovirus Infection in their offspring. METHODS. A case-control study of 519 women from a delivery population in Birmingham, AL, between December 1992 and July 1998 was undertaken to measure the association between maternal Cytomegalovirus exposures and an increased risk for congenital Cytomegalovirus Infection in their infants. Routine newborn Cytomegalovirus screening at the hospital identified infants with congenital Cytomegalovirus Infection. The cases (n = 150) were women who delivered an infant with congenital Cytomegalovirus Infection, and the control subjects (n = 369) were randomly selected from the delivery population of women whose newborns were uninfected. Investigation of exposures included using a standardized maternal interview, prenatal and medical chart abstraction, and laboratory confirmation of Cytomegalovirus Infection. RESULTS. Significant associations between congenital Cytomegalovirus Infection and caring for preschool children in the year before delivery, onset of sexual activity 3 people, and maternal age CONCLUSIONS. Caring for young children and recent onset of sexual activity contribute to an increased risk for congenital Cytomegalovirus Infection in the offspring of young women.
Frans Gordts - One of the best experts on this subject based on the ideXlab platform.
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hearing loss in children with congenital Cytomegalovirus Infection in relation to the maternal trimester in which the maternal primary Infection occurred
Pediatrics, 2008Co-Authors: Ina Foulon, Anne Naessens, Walter Foulon, Ann Casteels, Frans GordtsAbstract:OBJECTIVES. The purpose of this work was to study the relation between maternal trimester of primary Infection with Cytomegalovirus and the occurrence of sensorineural hearing loss in the congenitally infected offspring. PATIENTS AND METHODS. Thirty-four consecutive live-born children diagnosed with a congenital Cytomegalovirus Infection after maternal primary Cytomegalovirus Infections were included in the study. Five were lost for follow-up, and 1 died. Of the remaining 28 congenitally infected children, an estimation of the maternal trimester in which Cytomegalovirus primary Infection occurred was performed. All of the children were investigated for potential sensorineural hearing loss. RESULTS. Five of the maternal Infections occurred in the first trimester, 12 in the second trimester, and 11 in the third trimester of pregnancy. Sensorineural hearing loss was detected in 4 (80%) of the 5 congenitally infected children who were infected after a primary maternal Infection in the first trimester of pregnancy and in 1 (8%) of the 12 children when the maternal Infection occurred in the second trimester of pregnancy. No sensorineural hearing loss was detected after primary maternal Infection occurring in the third trimester. Fluctuation and improvement of sensorineural hearing loss were seen regardless the trimester of pregnancy during which maternal primary Infection occurred. Progression of sensorineural hearing loss occurred in 2 children born after a maternal primary Infection of the first trimester. CONCLUSIONS. Hearing loss seemed more common in infants with congenital Cytomegalovirus Infection who were born to women who experienced a primary Cytomegalovirus Infection in the first trimester of pregnancy than when Infection took place later in pregnancy.
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a 10 year prospective study of sensorineural hearing loss in children with congenital Cytomegalovirus Infection
The Journal of Pediatrics, 2008Co-Authors: Ina Foulon, Anne Naessens, Walter Foulon, Ann Casteels, Frans GordtsAbstract:Objective To determine the incidence, characteristics, and evolution of sensorineural hearing loss (SNHL) in infants with a congenital Cytomegalovirus Infection (cCMV). Study design In a prospective 10-year study, 14 021 unselected live-born infants were screened for cCMV by virus isolation in urine. Congenitally infected newborns were evaluated for SNHL during the first 5 years of life. Results A total of 74 of the 14 021 infants (0.53%) were congenitally infected; of these, 4 (5.4%) were symptomatic at birth. Hearing testing could be performed in 60 of the infants. SNHL was found in 21% of the asymptomatic and in 33% of symptomatic congenitally infected infants. Late-onset hearing loss was detected in 5%, progression in 11%, fluctuation in 16%, and improved hearing threshold in 18% of the infants with cCMV. SNHL was observed in 15% of infected infants born after a maternal primary Infection, in 7% born after a maternal recurrent Infection, and in 40% after a maternal Infection of indeterminate timing. Conclusions In our study population, 0.53% of the infants had cCMV Infection, 22% of whom developed SNHL. Long-term follow up and repeated audiologic testing is needed, because progression, fluctuation, improvement, and late-onset hearing loss are important features of cCMV Infection. The search for a neonatal screening program to detect all cCMV is worthwhile.
Suresh B Boppana - One of the best experts on this subject based on the ideXlab platform.
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congenital Cytomegalovirus Infection
Seminars in Perinatology, 2018Co-Authors: Karen B Fowler, Suresh B BoppanaAbstract:Each year, thousands of children are born with or develop permanent disabilities such as hearing loss, vision loss, motor and cognitive deficits from congenital CMV Infection (cCMV). However, awareness of cCMV and its associated sequelae is very low in pregnant women and healthcare providers. Both targeted and universal approaches to screen newborns for CMV Infection are now achievable due to recent scientific advances including the development of a rapid, high-throughput method for detecting CMV in saliva, the efficacy of antiviral treatment in symptomatic infants, and the demonstration of cost effectiveness of CMV screening. Future studies are needed to address gaps in our understanding on the role of non-primary maternal CMV Infections, the evaluation of antiviral treatment in asymptomatic infants, and the implementation of prevention strategies for cCMV.
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congenital Cytomegalovirus Infection in pregnancy and the neonate consensus recommendations for prevention diagnosis and therapy
Lancet Infectious Diseases, 2017Co-Authors: William D. Rawlinson, David W Kimberlin, Sophie Alain, Kate Daly, Sara Doutre, Laura Gibson, Tiziana Lazzarotto, Karen B Fowler, Suresh B Boppana, Michelle L. GilesAbstract:Summary Congenital Cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal Infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital Cytomegalovirus. Data in the literature suggest that congenital Cytomegalovirus Infection remains a research priority, but data are yet to be translated into clinical practice. An informal International Congenital Cytomegalovirus Recommendations Group was convened in 2015 to address these questions and to provide recommendations for prevention, diagnosis, and treatment. On the basis of consensus discussions and a review of the literature, we do not support universal screening of mothers and the routine use of Cytomegalovirus immunoglobulin for prophylaxis or treatment of infected mothers. However, treatment guidelines for infected neonates were recommended. Consideration must be given to universal neonatal screening for Cytomegalovirus to facilitate early detection and intervention for sensorineural hearing loss and developmental delay, where appropriate. The group agreed that education and prevention strategies for mothers were beneficial, and that recommendations will need continual updating as further data become available.
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clinical predictors of sensorineural hearing loss and cognitive outcome in infants with symptomatic congenital Cytomegalovirus Infection
Pediatric Infectious Disease Journal, 2016Co-Authors: Swetha G Pinninti, Karen B Fowler, Suresh B Boppana, Zdenek Novak, William J Britt, Shannon A RossAbstract:The objective of this study was to determine newborn clinical findings predictive of adverse clinical outcomes in infants with symptomatic congenital Cytomegalovirus Infection. Of 160 infants, significantly more children with central nervous system involvement had sensorineural hearing loss (P = 0.0
Yoram Bujanover - One of the best experts on this subject based on the ideXlab platform.
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portal vein thrombosis caused by protein c and protein s deficiency associated with Cytomegalovirus Infection
The Journal of Pediatrics, 1995Co-Authors: Ravit Aravboger, Shimon Reif, Yoram BujanoverAbstract:A 4-month-old girl who was examined because of splenomegaly had portal vein thrombosis, which apparently resulted from a combination of Cytomegalovirus Infection and deficiency of both protein S and protein C. The Cytomegalovirus Infection, by damaging endothelial cells, may have triggered a cascade of events that was ultimately expressed as portal vein thrombosis resulting from deficiency of proteins S and C.
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portal vein thrombosis caused by protein c and protein s deficiency associated with Cytomegalovirus Infection
The Journal of Pediatrics, 1995Co-Authors: Ravit Aravboger, Shimon Reif, Yoram BujanoverAbstract:A 4-month-old girl who was examined because of splenomegaly had portal vein thrombosis, which apparently resulted from a combination of Cytomegalovirus Infection and deficiency of both protein S and protein C. The Cytomegalovirus Infection, by damaging endothelial cells, may have triggered a cascade of events that was ultimately expressed as portal vein thrombosis resulting from deficiency of proteins S and C. (J PEDIATR 1995;126:586-8)
Gail J Demmlerharrison - One of the best experts on this subject based on the ideXlab platform.
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hearing loss in children with asymptomatic congenital Cytomegalovirus Infection
Pediatrics, 2017Co-Authors: Tatiana M Lanzieri, Winnie Chung, Marily Flores, Peggy Blum, Chantal A Caviness, Stephanie R Bialek, Scott D Grosse, Jerry Miller, Gail J DemmlerharrisonAbstract:OBJECTIVES: To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital Cytomegalovirus Infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children. METHODS: We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan–Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups. RESULTS: At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%–36%) among case-patients and 8% (95% CI: 3%–22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2–14.5; P = .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4–6.1; P = .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5–19.1; P CONCLUSIONS: Delayed-onset and progression of SNHL among children with asymptomatic congenital Cytomegalovirus Infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation.
