NEURORADIOGRAPHIC FINDINGS IN THE NEWBORN PERIOD AND LONG-TERM OUTCOME IN CHILDREN WITH SYMPTOMATIC CONGENITAL CYTOMEGALOVIRUS-INFECTION

Objective. To determine whether newborn cranial computed tomographic ( CT) scan abnormalities predict an adverse neurodevelopmental outcome i n children with symptomatic congenital cytomegalovirus (CMV) infection and to examine the association between clinical findings at birth and imaging abnormalities. Methods. The data from 56 children with sympto matic congenital CMV infection who underwent cranial CT scans as newbo rns and were enrolled in a long-term follow-up study were analyzed. Th e incidence of sequelae was compared between the groups of children wi th normal and abnormal imaging studies. The relationship between CT sc an results and other newborn findings was also examined. Results. Abno rmal CT scans were noted in 70% of subjects; intracerebral calcificati on was the most frequent finding. Most of the children with an abnorma l newborn CT scan (90%) developed at least one sequela, compared with 29% of those with a normal study. Only 1 child with a normal CT scan h ad an IQ <70, in contrast to 59% of those with imaging abnormalities. In addition, almost half of the children with CT abnormalities had an IQ <50 compared with none of those with a normal CT scan. Newborn CT a bnormalities were also associated with an abnormal hearing screen at b irth and hearing loss on follow-up. None of the neonatal neurologic fi ndings were predictive of an abnormal CT scan. Conclusion. In neonates with symptomatic congenital CMV infection, a cranial CT scan is a goo d predictor of an adverse neurodevelopmental outcome. In addition, new born clinical and laboratory findings did not predict neuroradiographi c abnormalities in neonates with symptomatic congenital CMV infection.