Intrauterine Cytomegalovirus infection a potential risk for Cerebral Palsy in kids

Previous studies demonstrated that the intrauterine exposure to infection, particularly cytomegalovirus (CMV), might be responsible for most cases of post-neonatally acquired CP. The inflammatory in the fetus is known as fetal inflammatory response syndrome, which can be activated by the maternal infection and is mediated by different cytokines. The fetal inflammatory response syndrome can induce neonatal white matter injury, which is a cause of fetal or neonatal injury that leads to motor impairment of CP in preterm-born children. However, little is known about the relationship between the intrauterine cytomegalovirus infection and the clinical features, neuroimaging findings of CP. Therefore, researchers of Children's Hospital of Nanjing Medical University, China conducted a study to explore the relationships between intrauterine CMV infection and clinical symptoms, classification, intelligence development and brain neuroimaging findings in children with CP.

It was a retrospective study, a total of 147 children with CP in recent 6 years were analyzed from January 2011 to December 2016. Researchers identified 148 children with CMV IgG and IgM positive sera using TORCH examination and they were selected as a control group. The children also undergone the examination of CMV-DNA in urine by CMV fluorescence quantitative PCR and researchers used t-test to analyze the number of copies. The researchers matched the age and sex of the control group with the cerebral palsy group. For the CP group, they used standardized rehabilitation treatment and evaluated the function of a gross motor by GMFM scale before and after treatment. They also used the Gesell developmental scale (GDS) to assess the level of intellectual development. Besides, they classified the CP and analyzed the MRI reports. They used the Pearson and Spearman correlation method to evaluate the correlations between the copy number of CMV-DNA and the clinical characteristics of children with CP.

Key findings of the study were:

♦ Upon analysis, researchers have found the level of CMV infection was negatively correlated with the developmental quotient (DQ) of children with CP.

♦ They also found a negative association between the level of CMV infection and the level of gross motor development.

♦ They found a positive association between the level of CMV infection and the occurrence probability of spastic quadriplegia.

♦ However, they found no associations between the abnormalities of brain tissue and the number of CMV copies.

♦ They reported CMV infection might add the difficulty of the rehabilitation treatment.

The authors concluded, "the results of our study demonstrated that individuals with CP have higher level of intrauterine CMV infection. Moreover, the severity of CMV infection is negatively correlated with the functional outcomes of children with CP. Therefore, infection is a risk factor for the occurrence of CP and intrauterine CMV infection should be taken seriously and treated. Early control of infection may reduce the disability of children with CP".

For further information:

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02449-3